[Predictive value of combined application of umbilical artery color Doppler velocimetry, nonstress testing and ultrasonography in monitoring umbilical cord entanglement].
OBJECTIVE
To explore the predictive value of combined application of umbilical artery color Doppler flow monitoring (CDFI), nonstress testing (NST) and ultrasonography in monitoring umbilical cord entanglement.


METHODS
1 860 cases of pregnant women between gestational ages of 37 approximately 42 weeks were studied 1 approximately 2 weeks before delivery by CDFI, nonstress testing (NST) and ultrasonography to monitor umbilical cord entanglement.


RESULTS
The prevalence rate of umbilical cord entanglement was 23.23% (432/1 860). Positive predictive value and negative predictive value were 95.4 % (412/432) and 98.6% (1 408/1 428) respectively. The rate of accuracy was 97.8% (1 820/1 860). The rate of fetal distress among the fetuses with umbilical cord round the body or four limbs was 85.29% (23/34) and the incidence of cesarean section in this group was 88.28% (30/34). The rate of fetal distress among the fetuses with umbilical cord round the neck was 13.06% (52/398) and the incidence of cesarean section in this group was 44.94% (178/398). The rates of fetal distress and cesarean section were significantly higher in the group with umbilical cord around the body or four limbs than in the group with umbilical cord around the neck (chi(2) = 107.27 and 23.76 respectively, P < 0.001). The systolic/diastolic (S/D) ratio was basically in normal ranges in the group with the umbilical cord round the neck. In cardiotopography (CTG), umbilical cord entanglement mainly showed variable deceleration (VD), early deceleration (ED), nonreaction on NST, and late deceleration (LD) on oxytocin challenge test (OCT). Prolonged fetal heart rate deceleration (PD) could be seen in the group with umbilical cord around the body or four limbs.


CONCLUSIONS
The combined application of umbilical artery color Doppler velocimetry, nonstress testing and ultrasonography have an important auxiliary value in monitoring umbilical cord entanglement. It remarkably increases the positive predictive rate as a valuable reference for the choice of delivery form.
Zhao
S
S
Department of Gynecology and Obstetrics, Affiliated Hospital of Medical College of Qingdao University, Qingdao 266003, China.
Dai
H
H
Shao
D
D
D000328:Adult; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D014470:Umbilical Cord / Q000000981:diagnostic imaging*