影响妊娠晚期胎头衔接的因素分析

Analysis of influence factors of engagement of fetal head in late pregnancy

目的探讨影响妊娠晚期胎头衔接的相关因素。方法回顾性分析2012年9月至2014年9月内江市中医医院产科收治的182例足月单胎、临产时胎头未衔接的产妇资料,其中50例阴道分娩,132例行剖宫产分娩,分析影响胎头衔接的相关因素。结果影响妊娠晚期胎头衔接最终行剖宫产主要因素有:胎位异常68例(51.52%),胎儿过大27例(20.45%)、脐带因素18例(13.64%)、胎盘因素13例(9.85%)、骨盆因素6例(4.54%)。结论临产时胎头未衔接,可能是难产的信号,应注意查找原因,制定适当的分娩计划,对无明显头盆不称者,应严密监测下充分阴道试产,对有明显头盆不称者适时剖宫产结束分娩。

Objective To explore the influence factors of engagement of fetal head in late pregnancy. Methods Clinical data of 182 full term puerperas with singleton who had non - engagement of fetal head during cesarean section in TCM Hospital of Neijiang City from Sep 2012 to Sep 2014 were retrospectively analyzed. 50 cases underwent vaginal delivery, 132 cases underwent cesarean section, the related factors affected engagement of fetal head were analyzed. Results The mainly factors affected engagement of fetal head included ： abnormal fetal position in 68 cases （51.52 % ）, fetal oversize in 27 cases （ 20. 45 % ）, umbilical cord factors in 18 cases （13.64 % ）, placental factors in 13 cases （9.85 % ）, pelvic factors in 6 cases （4. 54 % ）. Conclusion The non - engagement of fetal head during may be the signal of dystocia, it should pay attention to find the reasons and the formulation of appropriate delivery plan. For puerperas without obvious cephalopelvic disproportion, vaginal trial production should be applied under comprehensive monitoring, for puerperas with ob,.ious cephalopelvic disproportion, cesarean section should be applied timely.