正确处理头位难产在产科中的临床意义

The Clinical Significance of the Correct Treatment for Cephalic Presentation Dystocia

目的探讨正确处理头位难产在产科临床的意义。方法回顾性分析2010年5月至2011年11月在我院分娩的179例头位难产产妇的临床资料,分析头位难产的病因、临床特点、处理方法及预后。结果头位难产发生率为11.8%,胎头位置异常(60.9%)是首要原因,其次为头盆不称(21.2%),宫缩乏力(11.2%),软产道异常(6.7%)。107例枕横位和枕后位难产者,经改变母体体位、徒手转胎头等正确处理后,成功经阴道分娩者85例,成功率为79.4%。本组179例头位难产者,剖宫产率77.7%(139/179),经阴道分娩率22.3%(40/179)。产后出血发生率为1.1%(2/179),新生儿窒息发生率为1.7%(3/179)。结论及早、正确处理头位难产,有助于降低剖宫产率,减少并发症,改善预后。

Objective To explore the clinical significance of the correct treatment for cephalic presentation dystocia.Method 179 cases of clinical data with cephalic presentation dystocia from May 2010 to November 2011 were analyzed retrospectively,including pathogeny,clinical characteristics,processing method and prognosis.Results The occurrence of cephalic presentation dystocia was 11.8%,the main reason was abnormal fetal head position,followed by cephalopelvic disproportion（21.2%）,uterine atony（11.2%）,abnormal soft birth canal（6.7%）.After correct treatment,such as changes of maternal anthropometry,manual rotation of fetal head,85 cases were successful vaginal delivery,the successful rate was 79.4%.Of 179 cases,the rate of cesarean section was 77.7%（139/179）,vaginal delivery rate was 22.3%（40/179）.The incidence of postpartum hemorrhage was 1.1%（2/179）,the occurrence of neonatal asphyxia was 1.7%（3/179）.Conclusion Timely and correct treatment for cephalic presentation dystocia,could help to decrease the rate of cesarean section and complication,improve the prognosis.