胎儿持续性枕后位112例分析

Clinical Study on Fetal Persistent Occipital Posterior Position

目的探讨胎儿持续性枕后位的相关因素、产程特点及分娩预后。 方法 1997～ 1999年住院分娩 112例持续性枕后位初产妇的临床资料进行回顾性分析 ,并与同期枕前位 112例初产妇进行比较。 结果持续性枕后位组胎儿平均体重明显增大 ;骨盆临界狭窄、宫缩乏力及产程异常发生明显增加 ;总产程平均时间明显延长 ,尤其经阴道分娩者 ,除第三产程外 ,产程各期平均时间均明显增加。持续性枕后位组剖宫产率、难产率及胎儿窘迫、新生儿窒息、母体产褥病率均明显增加 ( P 均 <0 .0 5 )。 结论持续性枕后位是难产的主要原因之一 ,在第一产程时及早诊断与处理潜在问题并选择最佳分娩方式是提高围产期质量的关键。

Objective To study the characteristics of the labor course and perinatal prognosis of fetal persistent occipital posterior position (POPP). Methods We retrospectively analyed the clinical characteristics of 112 primipara with persistent occipital posterior fetal position (POPP group) and 112 primipara with occipital anterior fetal position (control group), from January 1997 to December 1999. Results In the POPP group, the indices of the average birth weight, abnormal bony pelvis and uterine inertia were significantly higher than those in the control group. The duration of labor was markedly longer and the incidence of abnormal labor course was markedly increased in the POPP group. The cesarean section rate was 76.79% and the total rate of operatire delivery was 95.45% in the POPP group versus 3.57% and 9.89% in the control group. The incidence of fetal hypoxia, neonatal asphyxia and puerperal morbidity was markedly high in the POPP group. Conclusion POPP is the major cause of dystocia. If management is unsuitable, perinatal prognosis will be poor. The study suggests that the obstetrician should utilize the partogram to discover abnormity in POPP labor, handle uterine inertia, and select the best pattern of labor on time.