肩难产的产前预测及产时处理分析

Analysis Antepartum Forecase and Intrapartum Treatment to Shoulder Dystocia

目的分析肩难产的产前预测及产时处理情况,减少肩难产引起的母儿并发症。方法回顾性分析本院1995年6月至2006年11月间25例肩难产,并随机抽取同期经阴道分娩30例设为对照组,比较两组间孕妇及新生儿情况并对产时肩难产的处理方法进行分析。结果两组孕妇孕周、体重、宫高、腹围、第一产程、第二产程比较,差异有显著性(P<0.01);两组新生儿体重、身长、头围、1分钟APGAR评分、B超胎儿双顶径(BPD)及股骨长径线(AD)比较,差异有显著性(P<0.01)。通过McRoberts手法耻骨联合上方加压法接生成功率最高。结论重视肩难产的产前预测和适当的产时处理,有助于防止母儿严重并发症的发生。

Objective Analysis antepartum foreease and intrapartum treatment to shoulder dystoc-ia, in order to decrease the complication of maternity and neonatal caused by shoulder dystocia. Methods 25 cases diagnosed as shoulder dystocia in our hospital during past 10 yeas were analyzed retrospec-tively, 30 cases eutocia at same term has been selected to be control group, the statue of maternity and neonatal between two groups were compared, analyze the treatment of intrapartum to shoulder dystocia. Results There were significant differences in gestational age, weight, height of furdus uterus, abdominal circumference, first stage of labor and second stage of labor between two groups of gravida （P〈0.01）. There were significant difference in height, head circumference, 1 rain Apgar＇s grade, B ultraso-nic BPD and AD between two groups of neonate （P〈0.01）. The succeed rate is the highest of technique with Mc Roberts and pressurize above pubic symphysis. Conclusion Recogniton antepartum foreease and intrapar-tum treatment to shoulder dystocia can help to avoid the severity compli cation.