肩难产高危因素的分析

Analysis on high risk factors of shoulder dystocia

目的:了解肩难产的发生率、并发症及处理方法,分析其高危因素。方法:回顾性分析6年间肩难产28例病历,并随机抽取同期阴道分娩的38例作为对照。比较两组产妇及新生儿的各项指标,分析巨大儿、糖尿病、产程异常、阴道助产等高危因素在肩难产中的比率,探讨肩难产的预防和处理。结果:6年间分娩总数为8400例,肩难产28例,占总数的0.33%,其中巨大儿15例,占肩难产的53.57%。两组产妇的宫高、腹围和产程有显著性差异(P<0.01),两组新生儿体重、Argar评分、双顶径、胸围有显著性差异(P<0.01)。结论:肩难产的发生率随胎儿体重增加而升高,通过高危因素预测并正确处理肩难产是降低围产儿及产妇并发症的重要措施。

Objective： To assess the incidence, treatment and complication of shoulder dystocia and analyse its high risk factors. Methods： Retrospective analysis in 28 cases of shoulder dystocia was perfomed to determine whether macrosomia, diabetes, operative vaginal delivery, labor abnormalities could predict shoulder dystocia. Thirty - eight cases of vaginal delivery were randomly selected as the control to assess the differences between the two groups and explore its prevention and treatment. Results： There were 28 cases of shoulder dystocia in 8 400 births, macrosomia was a feature in 15 infants. Shoulder dystocia rate was 0. 33% and macrosomia was 53. 57% of shoulder dystocia. The two groups had significant difference in the height of uterus, abdomen circumference and neonates＇ birth weigh, scores of Argar, head circumference. Conclusion： The incidence of shoulder dystocia increases with increment of embryo＇s weight, it is a important method to decrease the complication of perinatal badies and puerperal by predicating the high risk factors of shoulder dystocia.