初产妇头位难产的处理及临床分析

Management on cephalic presentation dystocia in primipara

目的对初产妇头位难产的处理方式进行临床分析。方法回顾性分析36例头位难产初产妇(难产组)和36例正常分娩初产妇(正常分娩组)的临床资料。结果正常分娩组产妇胎头下降停滞30例(83.33%),胎膜早破18例(50.00%),宫颈水肿20例(55.56%),第二产程延长7例(19.44%),原发宫缩乏力导致的潜伏延长24例(66.67%);正常分娩组胎头下降停滞11例(30.56%),胎膜早破2例(5.56%),宫颈水肿2例(5.56%),第二产程延长1例(2.78%),原发宫缩乏力导致的潜伏延长6例(16.67%),难产组各临床表现发生比率均高于正常分娩组,差异有统计学意义(P<0.01);难产组产妇行剖宫产17例(47.22%),经阴道分娩19例(52.78%),无产妇死亡。结论对初产妇的临床表现进行识别,及时纠正胎头异常情况,能够帮助产妇顺利分娩,降低剖宫产发生率,减少并发症的发生。

Objective To analyze the clinical management in primipara. Methods Clinical data of 36 primipara with cephalic on cephalic presentation dystocia presentation dystocia as observa- tion group and another 36 primipara with normal delivery as controls were retrospectively analyzed . Results Out of 36 patients in observation group, there were 30 cases（83.33% ） with protracted de- scent, 18 eases（50.00% ） with premature rupture of membrane, 20 cases（55.56% ） with cervical e- dema, 7 cases（ 19.44% ） with prolonged second stage and 24 cases（66.67% ） with delitescence de- lay by uterine inertia. Out of 36 patients in control group, there were 11 cases（30.56% ） with protrac- ted descent, 2 case（5.56% ） with premature rupture of membrane, 2 cases （5.56%）with cervical e- dema, 1 cases （2.78%）with prolonged second stage and 6 cases （16.67%）with delitescence delay by uterine inertia. There were 17 patients （47. 22% ） with caesarean section and 19 patients （52.78%）with vaginal delivery in the observation group. Conclusion Correcting abnormal fetal head position is important for reducing risk of section cesarean and complication.