持续性枕后位产程中的处理

Intrapartum Treatment of Persistent Occiput Posterior Position

目的根据持续性枕后位的产程特点,寻找最佳处理方法,减少剖宫产率,改善母儿预后。方法选择2013年1—3月在南京市妇幼保健院临产后确诊为枕后位产妇260例,随机分为两组:观察组予侧卧位纠正胎方位,对照组不予干预,充分试产,两组待宫口开全后若仍为枕后位,徒手旋转抬头,失败者选择剖宫产。结果观察组胎头自行纠正47例(36.2%),徒手旋转抬头成功65例(50%);对照组自行纠正0例,徒手旋转抬头成功87例(66.9%),两组比较,差异有统计学意义(P<0.05)。结论临产后通过进行体位纠正及徒手旋转胎头术,使大多数难产转为顺产,降低了剖宫产率。

Objective To find the best treatment to reduce cesarean section rate and improve the prognosis of mothers and babies according to the labor features of persistent occiput posterior posJition. Methods 260 pregnant women diagnosed as occiput posterior position in Nanjing Maternity and Child Health Care Hospital from January, 2013 to March, 2013 were randomly divided into two groups： the observation group was treated with lateral position to correct the fetal position, the control group was not intervened. If the fetal head did not turn itself while the cervix was completely opening, rotate the fetal head by hand, otherwise, choose cesarean section. Results In the observation group： 47 cases of fetal heads turned themselves （36.2%）, 65 cases were turned by manual rotation （50%）; the control group： 0 case turned itself, while 87 cases were turned by manual rotation （66.9%）, the data of the two groups were significantly different （P〈0.05）. Conclusion The change of posture and manual rotation of fetal head reduced cephalic dystocia and cesarean section rate.