104例剖宫产术中娩头困难的临床分析

Clinical Analysis of the Difficulty in Delivering the Fetal Head in 104 Cases with Cesarean Section

目的临床分析104例剖宫产术中娩头困难的原因及处理措施。方法整群选取该院2012年1月—2015年3月间收治的剖宫产术中娩头困难孕产妇104例临床资料进行分析。结果胎头高浮(17.31%)、麻醉效果不佳(52.88%、)、胎头过低(16.35%)、瘢痕子宫(9.62%)以及胎儿过大(3.85%)是剖宫产术中娩头困难的主要因素;术中采取相应措施后,3(2.88%)例子宫下端切口裂伤,8(7.69%)例新生儿窒息,转至新生儿科治疗后,均痊愈出院,母婴无其他并发症。结论剖宫产中多种因素可造成娩头困难,应做好相应对策,减少娩头困难发生率。

Objective To clinically analyze the causes of the difficulty in delivering the fetal head in 104 cases with cesare-an section and the countermeasures. Methods An analysis was conducted on the clinical data of 104 cases who had difficul-ty in delivering the fetal head during undergoing the cesarean section in our hospital from January 2012 to March 2015. Results The main factors that caused the difficulty in delivering the fetal head during undergoing the cesarean section were as follows：floating fetal head（17.31%）, poor anesthetic effect（52.88%）, too low fetal head（16.35%）, uterine scar （9.62%） and macrosomia（3.85%）. After taking the corresponding measures in the surgery, 3 cases（2.88%） with laceration of the lower end of the uterus, 8 cases （7.69%） with neonatal asphyxia were transferred to the Neonatal Department, and all were cured and discharged after treatment without other complications. Conclusion Many factors can cause the difficulty in delivering the fetal head in cesarean section. Countermeasures should be done well in order to reduce the incidence of difficulty in deliv-ering the fetal head.