Background The high work intensity and possible subsequently increased susceptibility to occupational hazards of calcium carbide plants may lead to hypertension in workers, but there are few studies on the relationship between occupational hazard exposure and hypertension in workers involving the production process of calcium carbide. Objective To explore the influence of occupational hazards on the incidence of hypertension in calcium carbide plants. Methods Using historical cohort design, the employees of a calcium carbide factory in the western part of Inner Mongolia Autonomous Region were selected as research subjects. According to the pre-determined inclusion and exclusion criteria, the study population comprised an exposure group of 377 employees (including furnace workers, inspection workers, and maintenance workers) exposed to dust, noise & carbon monoxide, and a control group of 388 employees (including central control workers, electricians, and administrative personnel) without above-mentioned exposure. The total sample size was 765 participants. The follow-up period was from April 2011 to October 2022, and the study endpoint was defined as the conclusion of the follow-up period or diagnosed hypertension in annual occupational health examination. Information on general demographic characteristics, living habits, and work status was collected from all study subjects. Cox proportional hazards regression model was used to analyze the association between occupational hazard exposure and the risk of hypertension among the calcium carbide plant employees. Results The average age, mean systolic and diastolic blood pressure, proportion of males, smoking rate, and alcohol consumption rate in the exposure group were higher than those in the control group (P<0.05). Compared to baseline, both systolic and diastolic blood pressure levels increased in the exposure group and the control group at the end of the follow-up (P<0.05). At the end of the follow-up, the average differences between systolic/ diastolic blood pressure and baseline values in the exposure group were higher than those in the control group (P<0.05). During the follow-up period, a total of 223 cases of hypertension occurred, with a total follow-up of 2785 person-years, resulting in an incidence density of 8007.18 per 100000 person-years, an average age of onset of (35.90±8.22) years, and an average working age of onset of (2.69±1.97) years. The incidence density in the exposure group was 128.71% higher than that in the control group, and the risk of hypertension in the exposure group was 2.115 times that of the control group. The risk of hypertension was 2.199 times higher for men than for women, 1.344 times higher for those aged 30 and above than for those under 30, 1.546 times higher for smokers than for non-smokers, and 1.750 times higher for drinking workers than for non-drinking ones. The results of Cox proportional hazards regression modeling indicated that the hazard ratio (95%CI) of hypertension among the employees exposed to dust, noise, and carbon monoxide was 2.254 (1.703, 2.982), 1.594 (1.107, 2.295), and 1.567 (1.079, 2.274), respectively, when different covariates (gender, age, smoking, and alcohol consumption) were included. The results of Log-rank test showed that there were statistically significant differences in the distribution of disease-free survival between the exposure group and the control group (P<0.05). Conclusion Occupational exposures to dust, noise, and carbon monoxide may increase the risk of hypertension among calcium carbide plant workers.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

OBJECTIVE To observe the efficacy of cetrorelix combined with aspirin in preventing early-onset ovarian hyperstimulation syndrome （OHSS）. METHODS A retrospective analysis was conducted on clinical data from 38 early-onset OHSS patients， who received treatment in our hospital from January 1st to July 1st， 2022. These patients were divided into intervention group （19 cases） and control group （19 cases） according to the therapy regimen. On the first day after oocyte retrieval surgery， the control group was given aspirin enteric-coated tablets 100 mg orally until menstruation began. The intervention group was given cetrorelix for injection 0.25 mg subcutaneously， for consecutive 3 days+aspirin enteric-coated tablets （same usage and dosage as the control group）. The first luteal phase， the degree of OHSS， and the ovarian volume， ascites volume， serum estradiol （E2）， white blood cell count （WBC）， hematocrit （HCT）， neutrophil ratio （NEUT%）， D-dimer （DD）， prothrombin time （PT）， fibrinogen （Fib） after oocyte retrieval surgery were observed and measured in 2 groups. RESULTS The first luteal phase was significantly shorter， and the proportions of median and severe OHSS cases were significantly lower in the intervention group compared to the control group （P＜0.05 or P＜0.01）. After oocyte retrieval surgery， the intervention group showed significantly lower ovarian volume， ascites volume， serum E2， WBC， NEUT%， HCT， DD and Fib compared to the control group， but PT of intervention group was signiticantly higher than that of control group （P＜0.05）. CONCLUSIONS Cetrorelix combined with aspirin is more effective in preventing early-onset OHSS than aspirin alone.

Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.