头位难产924例临床分析

Management of cephalic presentation dystocia: Clinical analysis of 924 cases.

本文分析我院头位难产924例临床资料,提示胎头方位异常占头位难产总数的70.56%,是发生头位难产的主要原因。产道异常和严重胎头方位异常必须采用剖宫产术结束分娩,本文剖宫产率为25.87%,占同期内剖宫产总数的41.86%。大多数胎头方位异常为枕横位和枕后位,必须进行试产,产前行头盆评分,临产后严密监护和观察以及给予催产素静滴、人工破膜、人工扩张和局部处理宫颈以及徒手旋转异常胎头方位等,以创造阴道分娩条件。本组试产结果88.61%能经阴道自产或手术助产分娩。因此,认为试产在头位难产中是必要的,它可以使难产转化为顺产,对母婴有利。

We have analysed 924 cases of cephalic presentation dystocia. The results showed that the malposition of fetal head was the chief cause of cephalic presentation dystocia and it accounted for 70.56% of all of cephalic presentation dystocia. Cesarean section proved to be the best method of delivery for the abnormal soft birth canal and severe malposition of fetal head. The incidence of cesarean section was 25.87% and accounted for 41.86% of all cesarean section performed during the same period. The majority malposition of fetal head was occipito-posterior and occipitotransverse presentation. They must undergo trying labour and at the same time be giveh medical care, cephalic labouring score, oxytocin infusion, artificial rupture of membrane, dilatation of cervix and manual rotation of malposition of fetal head etc, so that establish better conditions for vaginal delivery. The 88.61% of this group have given successful vaginal delivery (either spontaneous delivery or vacuum extractor and forcep delivery) after above management. Hence, our conclusion was that trying labour is very important and necessary in the management of cephalic presentation dystocia.