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      脐带绕颈

      【导读】照B超时医生要是说宝宝有脐带绕颈的症状,准妈妈不用太担心,有20%~25%的胎宝宝都会出现脐带绕颈,其中脐绕颈一周发生率为89%,一般都不会对宝宝构成影响或威胁,也不一定需要剖腹产。只有胎头不下降或胎心明显异常(也叫胎儿窘迫)的时候,才需要考虑是否手术哦!

      在脐带异常中,有一种症状叫做脐带绕颈。据统计,胎儿在孕妈妈肚子中长大期间,发生脐带绕颈的概率接近25%。而发生脐带绕颈一周的概率更高,已经超过了80%。那么,当胎儿发生脐带绕颈一周时,该怎么处理呢?

      1、注意胎动的次数

      数胎动是孕妈了解胎儿生长情况的方式之一,需要孕妈每天早中晚都要数。通常,宝宝12个小时内胎动的次数是有计算公式的,即将早中晚宝宝一个小时内的胎动次数相加乘以4。

      一般来说,正常的胎儿12个小时内的胎动次数大于10次,如果胎动次数过少或者过多,孕妈都需要去医院进行检查。

      2、采取左侧卧睡

      在孕期,孕妈在睡觉时,应该尽量采取左侧卧睡的方式,如此一来,腹中的胎儿会变得更干净,运动的次数也会更少,还能缓解脐带绕颈情况。

      3、少摸肚子少运动

      宝宝如果脐带绕颈一周,正常来说,这种情况会在孕后期逐渐消失。但在这个过程中,孕妈尽量不要经常抚摸肚子,也不能运动过于频繁,以免宝宝因为外界的刺激而家中脐带绕颈的情况。

      脐带内有维持胎儿生命的脐带血管,脐带血管长度较脐带长,平时血管卷曲呈螺旋状,而且脐带本身由胶质包绕,有一定的弹性,被脐带缠绕一周或脐带搭颈的胎儿,因脐带缠绕及压迫程度较轻,是不会发生临床症状的,这种缠绕对妈妈和宝宝的危险都不大,妈妈仍可经阴道将其顺利分娩。即使是脐带绕颈,由于胎头的活动性较小,只要脐带没有被勒紧,通常就不会危害胎儿健康。

      然而,脐带缠绕松紧与缠绕周数及脐带长短有关,缠绕得紧,就会影响脐带血流通过,造成胎儿缺氧,甚至死亡。临产时,当胎头下降时脐带受压或脐带相对过短,出现胎心减慢,胎头下降受阻,这时就要根据产程进展的情况及胎儿缺氧的状况决定是否需要剖宫产或阴道助产。

      脐带缠绕是脐带异常的一种,以缠绕胎宝宝颈部最为多见,是脐带异常中最重要的类型之一。

      在产前检查中,总有孕妇会被告知自己的胎儿脐带绕颈,脐带绕颈其实是一种较常见的现象。根据一项研究,在中国脐带缠绕胎宝宝颈部的发生率约为20%~25%,其中脐带绕颈一周发生率为89%,而脐带绕颈两周发生率为11%。

      脐带绕颈两周分为很多种,比如说怀孕30周脐带绕颈两周、怀孕35周脐带绕颈两周等,脐带绕颈3周以上或缠绕胎儿躯干、肢体的则比较少见。脐带有补偿性伸展,缠绕松弛对胎儿影响不大,缠绕过紧及多圈可影响胎儿血供,有造成胎心改变、围产儿缺氧、窒息甚至死亡的风险。实际上影响预后的关键因素不在绕颈周数,而在除去绕颈所剩的脐带长度。如虽只绕1周但相对长度过短,仍可造成惨痛结局。因脐带相对缩短,临产后影响胎先露下降,出现脐疝、子宫内翻、胎盘早剥、脐带断裂并不少见。发生在单羊膜囊双胎时危险更大。

      当宝宝有脐带绕颈现象的时候,孕妈妈就开始担心能够自然分娩了。确实,有部分孕妈妈是因为宝宝脐带绕颈而不得不选择剖腹产的分娩方式,可并非所有的脐带绕颈都必须选择剖腹产的,脐带绕颈也能顺产。

      脐带本身是有一定的长度的,而且富有弹性,所以脐带绕颈时,只要不过分拉扯,就不会影响宝宝的正常发育。同样的,如果缠在宝宝脖子上的脐带不紧而且足够长的话,那么还是可以选择顺产的,相反,如果脐带较短,绕颈的圈数过多而且很紧的话,那么就要听听医生的建议,选择剖腹产了。

      根据一项研究,在中国脐带缠绕胎宝宝颈部的发生率约为20%~25%,其中脐带绕颈一周发生率为89%,而脐带绕颈两周发生率为11%。脐带绕颈3周以上或缠绕胎儿躯干、肢体的则比较少见。脐带有补偿性伸展,缠绕松弛对胎儿影响不大,缠绕过紧及多圈可影响胎儿血供,有造成胎心改变、围产儿缺氧、窒息甚至死亡的风险。实际上影响预后的关键因素不在绕颈周数,而在除去绕颈所剩的脐带长度。如虽只绕1周但相对长度过短,仍可造成惨痛结局。因脐带相对缩短,临产后影响胎先露下降,出现脐疝、子宫内翻、胎盘早剥、脐带断裂并不少见。发生在单羊膜囊双胎时危险更大。

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