产时超声指导产妇体位矫正胎方位的探讨

Correction of occipiti-posterior position by maternal posture with guide of utrasonography during the process of labor

目的应用B超监测胎头方位指导产妇体位,探讨产程中改变产妇体位以矫正胎方位的临床效果。方法选择宫口开大3cm、B超检查判断为枕后位的初产妇220例,随机分为两组各110例,研究组在产程中指导产妇取侧俯卧位,使胎头在下降过程中逐渐从枕后位转至枕前位娩出。结果研究组转为枕前位84例,自然分娩率73.6%,两组比较有显著性差异,研究组活跃期为(194.6±21.5)min,第二产程平均(56.4±8.7)min,较对照组明显缩短。结论产时应用B超确定胎方位可准确指导产妇取侧俯卧位,能有效矫正枕后位。

Objective: To investigate the effect on correction of Occipio-Posterior (OP) presentation by changing maternal posture during labor. Methods: A protective study was conducted in 110 pregnant women when the cervix were already dilated up to 3 cm in diameter and the position of the presenting part were confirmed as occipito-posterior by Ultrasonography, women in babor were instructed to take the laberal posture so to get the resultant force of the gravity of the fetus, the buoyancy of amniotic fluid and the intermittent uterine contraction may change the fetal position from occipito-posterior uterine into occipito-anterio (OA) presentation. Another 110 women were selected as controls. Results: In the study group, 84 women delivered with fetal presentation changed from OP into OA, the rate of vaginal delivery were 73.6%, a significant difference was noted (P<0.005). The average time in the study group was (194.6+21.5) min for the active phase and (56.4+8.7) min for the second stage. Conclusions: It is an effective method for the mother to take the lateral posture on the same side of the fetal spine for correcting the OP position with the guide of ultrasonography.