胎头深定时子宫切口设计的探讨

Discussion of the design of uterine incision when the deep fixation of the fetal head

目的 探讨剖宫产术中遇胎头深定 ,改用取胎足方法分娩的子宫切口设计。方法 在子宫下段横形切开后 ,根据宫内胎儿肢体侧作为子宫切口向上延长 ,设计切口呈“”或“”型。结果 经临床应用 2 4例 ,术中取胎足容易 ,胎臀娩出顺利 ,无切口延裂 ,术中不增加失血量 ,术后 42d随访 ,未见子宫切口愈合不良征象。结论 “”或“”型切口设计合理 ,操作简便 。

Objective To discuss the uterine incision design in cesarean sections when the fetus' head deeply sunk in plevic,in this situation the method of reaching for the fetus's feet should be adopted. Method To incise uterine low and transversely then prolong the section according to the position of the fetus in the uterine, make the uterine-incision appear ''or'' shape. Result The method was practised in 24 cases, and it was found that it can help lying women deliver successfully fetus's bottom without expanding incision. Also in the operation there was no increased blood loss. When the patients were visited after 42 days, we finded no signs of unexpected uterine-incision healing problems. Conclusion ''or''shape incision is reasonably designed and it can be easily practised. The method of reaching for the fetus' feet when the fetus's head deeply sunk in plevic provides a new way for the choices of uterine-incision.