Endoscopical determination of umbilical cofd complications in labor

N. V. Strizhova, B. M. Petrikovsky

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Umbilical cord complications are the most frequent cause of perinatal morbidity and mortality [2, 8,10]. But when the umbilical pathology is diagnosed in time the prognosis for the fetus is better. 60 women with premature rupture of membranes were examined in labor with the help of an endoscope which was inserted into the amniotic cavity. The indications for the endoscopical examinations were suspicious on umbilical cord pathology after cardiotocography. In our study we also compared results obtained in two groups with the umbilical cord pathology: Group I – examined endoscopically in labor and group II (60 cases) – without endoscopical examination. For detection of possible looping of umbilical cord around the fetal neck one should insert the distal end of fibroscope äs deep äs 20-25 cm. In cases of a singje loop around the neck (23 cases – 38.3%) a blue-white cord-like strücture with daik-blue vessels under it’s surface can be visualised. Thus, we diagnosed the presence of two and more loops around the fetal neck also around it’s body and extremities. The determination of true and false knots of the umbilical cord during labor is a more complicated task because it is not always possible to follow the füll length of the cord. In 95 % the endoscopical results coincided with ones after the birth. In 5% the results were false negative. When the pathology of the umbilical cord was diagnosed in time the whole obstetricai tactic was changed. Thus the number of caesarean sections in I group was 11.7%against 5% in the II group; forceps deliveries were in 26.7% in the I group against 15% in the II; deliveries by vacuum-extraction were in 3.3 % against 9% in the II group. When comparing the results for the fetus the number of intranatal deaths were higher in 6 cases in the II group, the number of neonates, born with severe asphyxia was also higher in 4 cases. In recent years great progress has been obtained in the diagnosis of umbilical cord pathology with the use of ECG, FCC, cardiotocography [l, 3, 4, 5, 6, 9]. But the number of false results was 20-40%. The use of endosclopical examination makes it possible to reduce the number of diagnostical mistakes. Endoscopical examination allows to determine the concrete type of umbilical cord pathology which helps to choose the proper obstetricai tactic for the benefit of the fetus.

Original languageEnglish
Pages (from-to)48-53
Number of pages6
JournalJournal of Perinatal Medicine
Volume9
Issue number1
DOIs
StatePublished - 1981
Externally publishedYes

Keywords

  • Endoscopical examination
  • extremities
  • loops of umbilical cord around fetal neck
  • torso
  • true and false knots
  • umbilical cord complications

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