头位难产102例的临床分析.docVIP

头位难产102例的临床分析 【摘要】 目的：探讨头位难产对分娩方式的影响以及预防方法。方法：对102例头位难产产妇的临床资料进行回顾分析。结果：胎吸助娩9例，徒手转胎头8例，经阴道自然分娩23例，阴道分娩率为39.22%（40/102）。结论：头位难产的阴道分娩有一定的成功率，因此试产在头位难产中是必要的。 【关键词】 头位难产分娩方式 Abstract Aim:To discuss the dystocia of head birthrsquo;s effection on the means of childbirth.Method: Retrospectively analyse the clinical data of 102 cases of headbirh women.Result:The first main factor of the dystocia of headbirth is the abnormal position of the fetal head,and the second is the spirit of the lying-women.Among these 102cases of headbirth women,there are 27 who have distinct dissymmetry between the pelvis and the babyrsquo;s head.So they are not fit to have a trial birth and wait for a suitable time for a cutting uterus birth.The other 75 cases have no obvious dissymmetry between the pelvis and the fetusrsquo;s head， so they all have the trial bith when being in labor and were watched when giving bith.Result：Among them,9 cases are helped by attracting the fetus,8 cases are turned the fetal head by hand and 23 cases are born natually via cunt.The rate of childbirth via cunt is 39.22%(40/102).Conclusion:Put the fetal head right and attach importance to the effection on the uterine constractions by the spirit factor.The rate of the childbirth via cunt of this group of headbirth is 39.22% ,so the trial birth is very essencial in the headbirth. Key Words Fetal head dystocia;means of childbirh 资料与方法 2002年1月～2006年12月收治头位难产患者102例，其中27例存在明显头盆不称，不宜试产，临产后或择期行剖宫产术，14例骨盆狭窄（入口平面狭窄9例，中骨盆平面狭窄4例，出口平面狭窄1例），7例胎头双顶径ge;9.6cm、胎儿体重4000g以上，6例胎头位置严重异常（额位2例、前不均倾位2例、高直位1例、面先露1例），其余75例无明显骨盆异常，均在临产后试产，并观察产程进展。 结 果 临床表现：试产的75例中，胎头位置正常（枕前位）16例，12例因为产力异常而致难产, 原发宫缩乏力致潜伏期延长者4例，因继发宫缩乏力导致胎头下降延长或停滞、内旋转受阻出现活跃期停滞或延长8例。胎头位置异常59例中，枕后位36例，枕横位23例，原发宫缩乏力致潜伏期延长者3例，因继发宫缩乏力导致胎头下降延长或停滞、内旋转受阻出现活跃期停滞或延长35例，因持续性枕横位或枕后位出现第二产程延长者7例。轻、中度骨盆狭窄潜伏期活跃早期延长10例，活跃后期及第二产程延长甚至第二产程停滞2例，要求停止试产而行手术6例。 分娩方式：剖宫产62例（其中巨大胎儿、骨盆异常、胎头位置严重异常27例，潜伏期延长2例，活跃期延长或停滞伴胎儿宫内窘迫20例、伴持续性枕横位或枕后位者7例，要求剖宫产术6例），胎吸助产9例，徒手转胎头8例，经阴道自然分娩23例。 对母儿的影响：62例剖宫产中，术中出血600ml 6