Abstract：Objective To assess the feasibility of application of ultrasound in monitoring the umbilical CI (Cord Insertion) site during the first trimester, and to investigate the possible relevance between perinatal complications and the umbilical cord inserted in the 1/3 lower uterine segment in early pregnancy. Methods Altogether 302 pregnancies who accepted NT (Nuchal Translucency) scans at the 11th to 14th weeks of gestation and delivered in the hospital were selected. Scanned by color Doppler ultrasound, the pregnancies whose CI was located in 1/3 lower uterine segment were defined as Low CI Group; pregnancies whose CI was located in the middle or 1/3 upper uterine segment were defined as Normal CI Group. In all the cases, precise ultrasound assessments were required during pregnancies at the 28th~32nd weeks of gestation so as to detect the abnormalities of the placenta and umbilical cord, such as placenta previa, velamentous placenta and vasa praevia. All the cases were followed up until delivery and accepted the pathological examinations to observe the abnormalities of the placenta and umbilical cord after delivery or cesarean section. Results Among 302 cases of pregnancies, there were 50 cases in Low CI Group and 252 cases in Normal CI Group. The occurrence rates of placenta previa, abnormal CI (velamentous or marginal CI), placental malformation (accessory or bilobate placenta), abnormal intrapartum FHR (Fetal Heart Rate), low Apgar scores as well as emergency cesarean section in Low CI Group were higher than those of Normal CI Group with statistically significant differences (P<0.05), which indicated the higher incidence rate of abnormal CI, placental and umbilical cord malformation as well as perinatal complications in CI located in the 1/3 lower uterine segment in the first trimester. Conclusion Developmental abnormalities of the placenta and umbilical cord had relevance with the CI located in the 1/3 lower uterine segment in the first trimester. Screening for the cord insertion site at 11th~14th weeks of gestation had clinical significance for predicting abnormalities of the cord and the placenta at delivery.
李雪艳，于松. 超声监测孕11~14周脐带入口的临床价值[J]. 中国医疗设备, 2015, 30(8): 35-38.
LI Xue-yan, YU Song. Clinical Effectiveness of Application of Ultrasound in Monitoring Umbilical Cord Insertion at the 11. China Medical Devices, 2015, 30(8): 35-38.
Sepulveda W,Rojas I,Robert JA,et al.Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study[J].Ultrasound Obstet Gynecol,2003,21(6):564-569.
Nomiyama M,Toyota Y,Kawano H.Antenatal diagnosis of velamentous umbilical cord insertion and vasa previa with color Doppler imaging[J].Ultrasound Obstet Gynecol,1998,12(6):426-429.
[10]
Oyelese Y.Placenta previa and vasa previa:time to leave the Dark Ages[J].Ultrasound Obstet Gynecol,2001,18(2):96-99.
[11]
Sepulveda W,Rojas I,Robert JA,et al.Prenatal detection of velamentous insertion of the umbilical cord: a prospective color Doppler ultrasound study[J].Ultrasound Obstet Gynecol,2003,21(6):564-569.
[1]
Hasegawa J,Farina A,Nakamura M,et al.Analysis of the ultrasonographic findings predictive of vasa previa[J].Prenat Diagn,2010,30(12-13):1121-1125.
[2]
Hasegawa J,Matsuoka R,Ichizuka K,et al.Umbilical cord insertion site in early gestation and development of placenta[J].J Perinat Med,2009,37(5):481-485.
[2]
Hasegawa J,Matsuoka R,Ichizuka K,et al.Umbilical cord insertion site in early gestation and development of placenta[J].J Perinat Med,2009,37(5):481-485.
[4]
Hasegawa J,Matsuoka R,Ichizuka K,et al.Cord insertion into the lower uterine segment in first-trimester is associated with placenta and umbilical cord abnormalities[J].Ultrasound Obstet Gynecol,2006,28(2):183-186.
[4]
Hasegawa J,Matsuoka R,Ichizuka K,et al.Cord insertion into the lower uterine segment in first-trimester is associated with placenta and umbilical cord abnormalities[J].Ultrasound Obstet Gynecol,2006,28(2):183-186.
[5]
Hasegawa J,Matsuoka R,Ichizuka K,et al.Velamentous cord insertion and atypical variable deceleraions with no acceleraions[J].Int J Gynaecol Obstet,2005,90(1):26.
Nomiyama M,Toyota Y,Kawano H.Antenatal diagnosis of velamentous umbilical cord insertion and vasa previa with color Doppler imaging[J].Ultrasound Obstet Gynecol,1998,12(6):426-429.
[5]
Hasegawa J,Matsuoka R,Ichizuka K,et al.Velamentous cord insertion and atypical variable deceleraions with no acceleraions[J].Int J Gynaecol Obstet,2005,90(1):26.
