初产妇临产头浮阴道试产50例临床观察

Clinical Observation on 50 Cases of Vaginal Delivery of Primipara with Float Fetal Head

目的：探讨和总结初产妇临产时头浮经阴道试产分娩的临床经验。方法：选用在我院住院分娩的初产妇临产时头浮106例，随机分成两阻，50例为观察阻阴道试产；另56例为对照组直接行剖官产术。结果：两组剖宫产率比较：观察组剖宫产率高于对照组剖宫产率，差异有显著性（P〈0．01）；两组围产儿并发症比较：观察组胎儿宫内窘迫低于对照组胎儿宫内窘迫，差异有显著性（P〈0．05）；两组新生儿轻度窒息无差异性（P〉0．05），均无新生儿重度窒息、颅内出血及新生儿死亡；两组产妇并发症比较：两组先兆子宫破裂、产后出血无差异性（P〉0．05），均无产褥感染及产妇死亡；两组两组住院时间比较：观察组较对照组缩短3～4d拆线出院；结论观察组可降低剖宫产率，并可提前出院，但观察组会增加胎儿宫内窘迫。因此，试产中必需严密观察，一旦发现异常先兆，及时处理。

Objective： To explore the clinical experience of vaginal delivery of primiparas with float fetal head. Methods：One hundred and six cases of primipara deliveries with float fetal head were randomly selected in our hospital,and analyzed in two groups. The first 50 cases of vaginal delivery were in observation group; another 56 cases of caesarian section were in control group. Results：The comparison of caesarian section rate：the caesarian section rate of the observation group was significantly higher than that of the control group（P〈0.01）. The comparison of neonatal complications：the rate of fetal predicament of the observation group was significantly lower than that of the control group（P〈0.05）. There was no difference between the rate of slight neonatal asphyxia（P〉0.05）and both found no severe neonatal asphyxia,intracranid hemorrhage, and neonatal mortality. The comparison of the maternal complications： both found no aura uterine rupture,postpartum hemorrhage（P〉0.05）,and no puerperal infection,maternal death either. The comparison of the hospitalization time：as to the time for taking out stitches, in observation group there was three or four days shorter than that in the control group. Conclusion：In the observation group, the caesarian rate reduced,and the hospitalization time shortened, but the chance of fetal predicament increased. Therefore, the close observation is needed in delivery,and the immediate solution should be taken once abnormal conditions occur.