徒手旋转胎头在阴道分娩中的应用

Application of freehand rotation of fetal head in vaginal delivery

目的探讨徒手旋转胎头对头位难产产妇加速产程进展、提高自然分娩率、减少母婴并发症的作用。方法将212例单胎头位,持续性枕横位、枕后位,无严重并发症及合并症的产妇,随机分为观察组108例,采用手转胎头术;对照组104例,采用让孕产妇与大卤门方向一致的侧卧位。结果观察组产妇阴道分娩率显著高于对照组,剖宫产率显著低于对照组(P<0.01);产程进展时间、分娩方式、产后出血等方面与对照组比较差异有统计学意义(P<0.01)。结论对持续性枕横位或枕后位的产妇适时采用徒手旋转胎头方法,转至枕前位,可使难产转为顺产,缩短产程,提高自然分娩率,降低剖宫产率,减少母婴并发症。

Objective To investigate the effect of freehand rotation of fetal head on accelerating labour process,in- creasing natural delivery rate and reducing maternal and child complications in cephalic presentation. Methods 212 puerperae with continuous transverse position and occipitoposterior position and without severe complications and co- morbidities were selected and randomly divided into the observation group with 108 patients received freehand rotation of fetal head and the control group with 104 patients adopted the lateral position consistent with the direction of fontanel. Results The observation group had significantly higher vaginal delivery rate and significantly lower cesarean section rate than the control group （P〈0.01）;The two groups were significantly different in the labour process time,de- livery mode and postpartum hemorrhage （P〈0.01）. Conclusion The application of freehand rotation of fetal head in puerperae with continuous transverse position or occipitoposterior position can change difficult labour into natural labour,shorten labour process,increase natural delivery rate,decrease cesarean section rate and reduce maternal and child complications.