臍帯脱出
WordNet
- stack in cords; "cord firewood"
- a unit of amount of wood cut for burning; 128 cubic feet
- a cut pile fabric with vertical ribs; usually made of cotton (同)corduroy
- a light insulated conductor for household use (同)electric cord
- a line made of twisted fibers or threads; "the bundle was tied with a cord"
- bind or tie with a cord
- slip or fall out of place, as of body parts; "prolapsed rectum"
- the slipping or falling out of place of an organ (as the uterus) (同)prolapsus, descensus
- relating to or resembling the umbilicus; "umbilical cord"
- of textiles; having parallel raised lines (同)twilled
PrepTutorEJDIC
- 〈U〉〈C〉『綱,ひも』(stringより太くropeより細い) / 〈U〉〈C〉束縛,きずな / 〈C〉〈U〉(電気の)『コード』,線 / (またchord)〈C〉(動物体の)索状組織,腱(けん) / 〈C〉うね織り,(特に)コールテン;(うね織りの)うね;《複数形で》コールテンのズボン / 〈C〉コード(材木の容積の単位で約6.25m) / …'を'綱(ひも)で縛る
- (腸・子宮などの)脱出,下垂
- へその
- (驚いて)わあっ,えっ
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/12/17 12:08:11」(JST)
[Wiki en表示]
Umbilical cord prolapse |
Classification and external resources |
Cord prolapse, depicted by W.Smellie, 1792
|
ICD-10 |
O69.0, P02.4 |
ICD-9 |
663.0, 762.4 |
DiseasesDB |
13522 |
eMedicine |
med/3276 |
Umbilical cord prolapse happens when the umbilical cord precedes the fetus' exit from the uterus. It is an obstetric emergency during pregnancy or labor that imminently endangers the life of the fetus. Cord prolapse is rare.[1] Statistics on cord prolapse vary, but the range is between 0.14% and 0.62% of all births in most studies.[2]
Cord prolapse is often concurrent with the rupture of the amniotic sac. After this happens the fetus moves downward into the pelvis and puts pressure on the cord. As a result, oxygen and blood supplies to the fetus are diminished or cut-off and the baby must be delivered quickly.
Treatment and mortality rate[edit]
Some practitioners will attempt to reduce pressure on the cord and deliver vaginally right away. Frequently the attempt to resolve the prolapsed cord and deliver the baby vaginally fails, and an emergency caesarean section must be performed immediately.[3] While the patient is being prepared for a caesarean, the woman is placed in the Trendelenburg position or the knee-elbow position,[4] and an attendant reaches into the vagina and pushes the presenting part out of the pelvic inlet and back into the pelvis to remove the pressure from the umbilical cord.[5] If attempts to deliver the baby promptly fail, the fetus' oxygen and blood supply are occluded and brain damage or death will occur.
The mortality rate for the fetus is given as 11–17%.[6] This applies to hospital births or very quick transfers in a first world environment. One series is reported where there was no mortality in 24 cases with the novel intervention of infusing 500ml of fluid by catheter into the woman's bladder, in order to displace the presenting part of the fetus upward, and to reduce compression on the prolapsed cord[citation needed]; however a recent trial comparing manual support alone (n=29) versus manual support plus bladder-filling (n=15) showed no added benefit in terms of neonatal outcome.[7]
Risk factors[edit]
Potential predisposing risk factors include:[8]
- Premature rupture of the amniotic sac
- polyhydramnios (having a large volume of amniotic fluid). The cord may be forced out with the more forceful gush of waters.
- long umbilical cord
- fetal malpresentation
- multiparity
- multiple gestation
References[edit]
- ^ http://www.emedicine.com/med/topic3276.htm
- ^ http://www.uptodate.com/patients/content/topic.do?topicKey=labordel/2191
- ^ http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijgo/vol1n1/cord.xml
- ^ http://www.patient.co.uk/showdoc/40000243/
- ^ http://books.google.com/books?id=fAf1wCTRRCUC&pg=PA234&lpg=PA234&dq=cord+prolapse+management&source=web&ots=Lgdg1LLvtj&sig=9osvwQy00PHO4PTaBJ6Vn-liUZM&hl=en&sa=X&oi=book_result&resnum=6&ct=result
- ^ http://www.gpnotebook.co.uk/simplepage.cfm?ID=1785397303 GP Notebook. Mortality 11-17%.
- ^ http://www.springerlink.com/content/tu50074545302217
- ^ http://www.uptodate.com/patients/content/topic.do?topicKey=labordel/2191
Pathology of pregnancy, childbirth and the puerperium (O, 630–679)
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Pregnancy |
Pregnancy with
abortive outcome
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- Ectopic pregnancy
- Abdominal pregnancy
- Cervical pregnancy
- Interstitial pregnancy
- Ovarian pregnancy
- Molar pregnancy
- Miscarriage
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Oedema, proteinuria and
hypertensive disorders
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- Gestational diabetes
- Gestational hypertension
- Pre-eclampsia
- Eclampsia
- HELLP syndrome
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Other, predominantly
related to pregnancy
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Digestive system
|
- Acute fatty liver of pregnancy
- Hepatitis E
- Hyperemesis gravidarum
- Intrahepatic cholestasis of pregnancy
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Integumentary system /
dermatoses of pregnancy
|
- Gestational pemphigoid
- Impetigo herpetiformis
- Intrahepatic cholestasis of pregnancy
- Linea nigra
- Prurigo gestationis
- Pruritic folliculitis of pregnancy
- Pruritic urticarial papules and plaques of pregnancy (PUPPP)
- Striae gravidarum
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Nervous system
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|
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Blood
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- Gestational thrombocytopenia
- Pregnancy-induced hypercoagulability
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Maternal care related to the
fetus and amniotic cavity
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- amniotic fluid
- Oligohydramnios
- Polyhydramnios
- Braxton Hicks contractions
- chorion / amnion
- Amniotic band syndrome
- Chorioamnionitis
- Chorionic hematoma
- Monoamniotic twins
- Premature rupture of membranes
- Obstetrical hemorrhage
- placenta
- Circumvallate placenta
- Monochorionic twins
- Placenta praevia
- Placental abruption
- Twin-to-twin transfusion syndrome
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|
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Labor |
- Amniotic fluid embolism
- Cephalopelvic disproportion
- Dystocia
- Fetal distress
- Obstetrical hemorrhage
- placenta
- Preterm birth
- Postmature birth
- Umbilical cord prolapse
- Uterine rupture
- Vasa praevia
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Puerperal |
- Breastfeeding difficulties
- Agalactia
- Fissure of the nipple
- Galactorrhea
- Diastasis symphysis pubis
- Peripartum cardiomyopathy
- Postpartum depression
- Postpartum thyroiditis
- Puerperal fever
- Puerperal mastitis
|
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Other |
- Concomitant conditions
- Diabetes mellitus
- Systemic lupus erythematosus
- Thyroid disorders
- Maternal death
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|
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Certain conditions originating in the perinatal period / fetal disease (P, 760–779)
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Maternal factors and
complications of pregnancy,
labour and delivery |
placenta: Placenta praevia · Placental insufficiency · Twin-to-twin transfusion syndrome
chorion/amnion: Chorioamnionitis
umbilical cord: Umbilical cord prolapse · Nuchal cord · Single umbilical artery
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Length of gestation
and fetal growth |
Small for gestational age/Large for gestational age · Preterm birth/Postmature birth · Intrauterine growth restriction
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Birth trauma |
scalp (Cephalhematoma, Chignon, Caput succedaneum, Subgaleal hemorrhage) · Brachial plexus lesion (Erb's palsy, Klumpke paralysis)
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By system |
Respiratory
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Intrauterine hypoxia · Infant respiratory distress syndrome · Transient tachypnea of the newborn · Meconium aspiration syndrome · pleural disease (Pneumothorax, Pneumomediastinum) · Wilson-Mikity syndrome · Bronchopulmonary dysplasia
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Cardiovascular
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Pneumopericardium · Persistent fetal circulation
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Haemorrhagic and
hematologic disease
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Vitamin K deficiency (Haemorrhagic disease of the newborn)
HDN (ABO • Anti-Kell • Rh c • Rh D • Rh E) · Hydrops fetalis · Hyperbilirubinemia (Kernicterus, Neonatal jaundice)
Velamentous cord insertion
Intraventricular hemorrhage (Germinal matrix hemorrhage)
Anemia of prematurity
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Digestive
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Ileus · Necrotizing enterocolitis · Meconium peritonitis
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Integument and
temperature regulation
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Erythema toxicum · Sclerema neonatorum
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Nervous system
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Periventricular leukomalacia
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Musculoskeletal
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Gray baby syndrome · muscle tone (Congenital hypertonia, Congenital hypotonia)
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Infectious |
Vertically transmitted infection (Congenital rubella syndrome, Neonatal herpes simplex) · Omphalitis · Neonatal sepsis (Group B streptococcal infection) · Neonatal conjunctivitis
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Other |
Perinatal mortality (Stillbirth, Infant mortality) · Neonatal withdrawal
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UpToDate Contents
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English Journal
- Intrapartum fetal heart rate patterns preceding terminal bradycardia in infants (>34 weeks) with poor neurological outcome: A regional population-based study in Japan.
- Kodama Y1, Sameshima H1, Yamashita R1, Oohashi M1, Ikenoue T1.
- The journal of obstetrics and gynaecology research.J Obstet Gynaecol Res.2015 Nov;41(11):1738-43. doi: 10.1111/jog.12797. Epub 2015 Sep 30.
- AIM: Intrapartum fetal bradycardia necessitates immediate operative delivery. Our aim was to investigate the hypothesis that some non-reassuring fetal heart rate (FHR) patterns were present before the onset of terminal bradycardia in infants who developed subsequent brain damage.MATERIAL AND METHODS
- PMID 26419405
- Prenatal Vesico-allantoic Cyst Outcome - A Spectrum from Patent Urachus to Bladder Exstrophy.
- Riddell JV1, Houle AM2, Franc-Guimond J2, Barrieras D2.
- Prenatal diagnosis.Prenat Diagn.2015 Oct 7. doi: 10.1002/pd.4702. [Epub ahead of print]
- OBJECTIVE: To assess the prognostic significance of a cystic vesico-allantoic communication discovered on prenatal ultrasound in terms of its effect on the developing urinary tract.METHODS: Multi-institution review of prenatal screening ultrasound was performed between 2004-2015 to identify cases of
- PMID 26443202
- Effect of early amniotomy on dystocia risk and cesarean delivery in nulliparous women: a randomized clinical trial.
- Ghafarzadeh M1, Moeininasab S, Namdari M.
- Archives of gynecology and obstetrics.Arch Gynecol Obstet.2015 Aug;292(2):321-5. doi: 10.1007/s00404-015-3645-x. Epub 2015 Feb 10.
- PURPOSE: Artificial rupture of amniotic membranes (amniotomy) which induces or accelerates labor is the most common obstetrical procedure. There is controversy about the effect of early amniotomy on dystocia and cesarean delivery. The study aim was to determine the effect of early amniotomy on the r
- PMID 25666481
Japanese Journal
- Labor induction by transcervical balloon catheter and cerebral palsy associated with umbilical cord prolapse
- Yamada Takahiro,Cho Kazutoshi,Yamada Takashi,Morikawa Mamoru,Minakami Hisanori
- Journal Of Obstetrics And Gynaecology Research 39(6), 1159-1164, 2013-06
- … Aim The aim of this study was to determine whether the use of transcervical balloon catheter (TCBC) for induction of labor (IOL) is a risk factor for cerebral palsy (CP) associated with umbilical cord prolapse (UCP-CP) in singleton pregnancies with cephalic presentation. …
- NAID 120005438222
- 3) 産科処置の際の基本的留意事項 : (2)人工破膜の留意点(共同企画-1 産科医療補償制度原因分析委員会より 脳性麻痺児発生予防のために,第64回日本産科婦人科学会学術講演会生涯研修プログラム関係講演要旨)
- 分娩誘発時におけるメトロイリンテルでの臍帯脱出の検討
- 鈴木 貴士,村越 毅,北代 祐三,岩田 典子,佐藤 奈菜香,塩島 聡,松下 充,神農 隆,石井 桂介,松本 美奈子,成瀬 寛夫,鳥居 裕一
- 日本周産期・新生児医学会雑誌 = Journal of Japan Society of Perinatal and Neonatal Medicine 48(1), 36-40, 2012-05-20
- NAID 10030647734
Related Links
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- Umbilical cord prolapse is a rare obstetrical emergency that occurs when the umbilical cord descends alongside or beyond the fetal presenting part. It is life-threatening to the fetus since blood flow through the umbilical vessels is ...
★リンクテーブル★
[★]
- 英
- prolapsed umbilical cord, umbilical cord prolapse, prolapse of the umbilical cord
- ラ
- dessus funiculi umbilicalis
- 関
- 臍帯
疫学
- 頭位:0.2-0.3%、骨盤位:5%、横位:1% (NGY.459)
成因
- 破水後に臍帯が先進部と骨盤入口面・産道の間を通過するために生じる。
原因
徴候
- NGY.459
- 破水と同時に激しい胎動と著明な心拍数の低下
- 胎便による羊水の混濁を見る
検査
治療
[★]
- 関
- aberration、departure、deviate、deviation、diverge、escape、hernia
[★]
- 関
- chorda、chordae、chordal、code、tendon、trabecula、trabeculae
[★]
- 関
- (n.)precordia 前胸部、(adj.)precordial 前胸部の
[★]
- 関
- herniated
- prolapsed true hemorrhoids. internal hemorrhoids
[★]
臍の
- 関
- hilum、navel、umbilicus