胎头深定剖宫产两种取胎方法的临床分析

Analysis of two ways to pull out baby during cesarean section in the condition of fetal head deeply fixed in the pelvic

目的:探讨胎头深入盆且固定时(简称胎头深定)剖宫产的两种取胎方法,指导临床选用一种更合理安全的取胎方法,从而使胎头深定剖宫产对母儿的危害降到最低。方法:回顾性分析我院2009年1月至2011年1月胎头深定剖宫产的孕妇45例,将患者分成两组,一组剖宫产术中用牵引胎足臀位取胎法(观察组),一组剖宫产术中取胎用阴道上推胎头头位取出法(对照组),对两种不同取胎方法进行临床比较。结果:观察组患者术中子宫切口裂伤、出血量、手术时间方面显著低于对照组,术后产褥病率、住院时间均低于对照组,差异有统计学意义。新生儿损伤、窒息、胎儿娩出时间两组无明显差异。结论:对于胎头深定时剖宫产选用牵引胎足臀位取胎法相对较安全,在我们临床可以选用。

Objective To evaluate the safety of two ways to pull out baby during cesarean section in the condition of fetal head deeply fixed in the pelvic. Methods 45 women delivered in our hospital from Jan 2009 to Jan 2011, who received emergency cesarean section and with fetal head deeply fixed in the pelvic, were divided into 2 groups. Women in observation group received baby delivery by pulling fetal feet, and those in control group by pushing fetal head in the vaginal to reach the head. Results Significant differences were found in the laceration rate, the amount of bleeding, the time of operation, the puperium fever rate, and the days stayed in hospital between the two groups, and there was no significant difference in neonatal damage, asphyxia, and delivered time of baby. Conclusion Fetal foot traction could be a relatively safe method in cesarean sections in the condition of fetal head deeply fixed in the pelvic.