肩难产相关因素及防范对策探讨

Study on Related Factors of the Shoulder Dystocia and Preventive Measures

【目的】探讨肩难产发生的相关因素及防范措施。【方法】1994年8月至2004年8月发生的76例肩难产病例中随机抽取30例,并抽取同期正常分娩30例做对照。比较两组间产前、产时指标,新生儿体重及母婴分娩并发症差异。【结果】两组在宫高、腹围、妊娠糖尿病、多产、新生儿体重、第二产程延长,产后出血,软产道损伤及新生儿损伤等方面差异有显著性(P<0.01)。【结论】肩难产与巨大胎儿,妊娠糖尿病,经产妇,第二产程延长有关。预测肩难产对于防治妊娠并发症及新生儿损伤有重要意义。

[Objectivellnvestigation on the high risk factors related to shoulder dystocia and preventive measures. [Methods] From August 1994 to August 2004, using the random and doubleblind method. 30 from 76 shoulder dystocia cases were used as shoulder dystocia group and 30 cases of normal labours as matched control. The prenatal and natal periods indexes, new born＇s weight and the perinatal outcome were compared between two groups. [Results] There were significant differences of the two groups in height of the uterus , fetal abdominal circumference, gestational diabetes, fecundity , newborns＇ weight, prolonged second stage of labour, assisted vaginal delivery, postpartum hemorrhage, injury of soft birth canal and newborn damage. [Conclusion]Shoulder dystocia is markedly related with the fetal maerosomia,gestational diabetes mellitus,multipara,prolonged second stage. Prediction of shoulder dystocia is important for the prevention of gestation complications and newborn damage.