评估脐带异常在胎儿死亡中的作用——一个机构经验

Fakeha Begum, P. Mounika, M. Pavane, C. Ramya
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摘要

脐带在胎儿发育和健康中起着至关重要的作用。脐带的任何异常都可能影响胎儿的生存能力。尽管存在产前诊断方式,但胎儿尸检在识别和确认导致宫内胎儿死亡的异常方面仍起着至关重要的作用。目的:探讨围产期胎儿死亡中各种脐带异常的发生率。本研究对2013年1月至2021年7月在三级保健中心进行的26例因脐带异常导致的围产期死亡进行回顾性观察研究。在这项研究中,26例胎儿尸检包括在9年的时间。产妇平均年龄为26岁。血管数缺损12例(44.3%)。其中2支支索11例,5支支索1例,短索14例。8例脐带长度正常。4例显示长声带。在一个病例中发现了真正的结。3例(28%)涉及声带狭窄。超捻线5例(28.4%)。3例出现产妇合并症。脐带异常是胎儿的主要应激因素,在胎母灌注中起关键作用。脐带异常可能在临床上不明显,也可能严重导致胎儿死亡。本研究再次强调脐带的重要性及其对胎儿健康的影响。因此,有必要制定专门的产前筛查脐带异常需要进一步的研究。
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Evaluation of role of umbilical cord anomalies in fetal death-An institutional experience
Umbilical cord plays pivotal role in development and well being of fetus. Any abnormality in the umbilical cord can affect the viability of the fetus. In spite of presence antenatal diagnostic modalities still fetal autopsy plays a vital role in identification and confirmation of the abnormalities which lead to intrauterine fetal death. To check for incidence of variety of cord abnormalities in perinatal fetal deaths. It is a retrospective observational study of 26 cases of perinatal deaths due to cord abnormalities taken from Jan 2013 to July 2021 in tertiary care center. In the study 26 cases of fetal autopsy were included over a period of nine years. Mean maternal age was 26 years. 12 cases (44.3%) were of vessel number defects. In which 11 were two vessel cords and the other was 5 vessel cord, 14 cases showed short cord. 8 cases showed normal cord length. 4 cases showed long cords. True knots were seen in one case. 3 cases (28%) were involving stenosed cords. and 5 cases (28.4%) were of supercoiling 3 twisted cords. Maternal co-morbidities were present in 3 cases.Umbilical cord anomaly is a major stress factor for fetus playing a key role in feto-maternal perfusion. Cord abnormalities can be clinically insignificant or can be severe leading to foetal death. The present study reemphasizes the importance of umbilical cord and its impact on wellbeing of foetus. Thus there is need to develop special and exclusive antenatal screening for umbilical cord abnormalities needs further research.
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