持续性枕横位及枕后位的产程特点及围产儿预后

The Characteristics of Labour Course and Perinatal Prognosis in Cases of Fetal Persistent Occiput transverse Position and Persistent Occiput posterior Position

目的：探讨持续性枕横位及枕后位的产程特点及围产儿预后。方法：采用回顾性资料分析方法，对１９９５年１１月至１９９６年７月在我院分娩的持续性枕横位及枕后位孕妇的临床资料进行分析。并与同期枕位正常的９０例（对照组）孕妇进行比较。结果：枕位异常者，胎儿体重过大、宫缩乏力的比例明显增加，产程各期时间均明显延长，胎先露下降速度明显减慢，各产程异常发生率明显增加，手术产率明显增加。枕横位总手术产率为８２．８１％，枕后位为９２．３１％，胎儿宫内缺氧、新生儿窒息率明显增加。结论：持续性枕横位及枕后位是难产的主要原因之一，若处理不当，围产儿预后欠佳。

Objectives: To study the characteristics of the labour course and perinatal prognosis in cases of fetal persistent occiput transverse position (POTP) and persistent occiput posterior position (POPP). Methods: All the cases, delivered with POTP and POPP in our hospital from Nov, 1995 to July, 1996 were analyzed retrospectively. Results: In abnormal fetal occipital position group, the following indices were significantly higher than those of normal group: fetal macrosomia, uterine inertia, and duration of each labour course. The speed of descending of presentation was obviously slower. The incidence of abnormal labour course was markedly increased. The rate of operative delivery was significantly higher. The total rate of operative delivery was 82.81% in the POTP group, and 92.31% in the POPP group. The incidence fetal hypoxia and neonatal asphyxia was markedly high in the abnormal occiput group. Conclusions: The POTP and POPP are major cases of dystocia. If management is unsuitable, perinatal prognosis will be poor.