二种不同胎方位低位产钳术对母婴的影响

Impact of low forceps of two difference position of the fetus on the maternity and children.

根据美国妇产科学会低位产钳术的新标准，对我院１９９４年８月－１９９６年７月，２年中１６６例低位产钳分为ＯＡ位与ＯＰ位分析两组低位产钳术对母婴的影响。结果，产钳指征以Ⅱ产程延长居第１位５６％，其次为胎儿宫内窘迫为４０．９％，新生儿并发症以面部擦伤、面神经损伤、窒息、锁骨骨折多见，两组比较，ＯＰ位组明显高于ＯＡ位组Ｐ＜０．００１。母体并发症以阴道壁裂伤、宫颈裂伤、会阴撕裂为主，两组比较差异无显著性Ｐ＞０．０５。１０２例ＯＰ位徒手转胎位至ＯＡ位７３例，未转胎位２９例，新生儿窒息ＯＡ与ＯＰ两组比较差异有显著性Ｐ＜０．００１。我们认为，低位产钳术虽是一个较安全有效的助产手段，但不能忽视ＯＰ位低位产钳术对新生儿所致的产伤。

With the new standard of American Academy of obstetris about low forceps, there were low forceps of 166 in our hospital from 1994. 8 to 1996. 7 of which were divided into groups position of OA and OP that were analyzed impact of low forceps on the maternity and child. The results showed that indication of forceps was deley in the second stage 56% and fetal distress 40 9%, complication of neonatal were trauma of the face, facioplegia, asphyxia and fracturs of the clavicle more often. Compared with two groups: OP group was highter than the OA group P<0.001, complication of mother were trauma of the vaginal wall, trauma of the cervix, and laceration of the perineum. There was no obvious difference as compared with two groups P>0.05. There were 102 cases, inclueling 73 were transfered with your hands from OP to OA, and 29 were not transfer position of fetus. Asphyxia of neonatal were statistically significant as compared with the two groups P<0.001. It indicated that low forceps would be a saften and efficient for assistant means, but low forceps of OP would be caused of bith truma that should be pay attention to by us. The results suggested the forceps for assitant that should be transfer position of fetus from OP to OA to avoid the complication of the mother and children.