孕晚期单胎臀位孕妇实施无镇痛外倒转术临床分析

Clinical Analysis of Non-analgesia External Inversion in Late Pregnancy

目的探讨对孕晚期单胎臀先露孕妇实施外倒转术的安全性及相关因素。方法收集银川市妇幼保健院2017年9月—2019年3月定期产检并于孕晚期明确诊断单胎臀位且有意愿行外倒转术的21例孕妇作为研究对象,实施无镇痛外倒转术,根据术后结果将其分为成功组和失败组,比较两组孕妇临床资料,追踪妊娠结局并分析并发症发生情况。结果21例外倒转孕妇中,成功11例(52.4%),失败10例(47.6%),先露未衔接的孕妇外倒转成功率高于先露衔接者(P<0.05);不同产次、臀先露类型、胎盘位置、脐带绕颈情况以及胎儿体质量的孕妇外倒转成功率差异均无统计学意义(P均>0.05)。成功组孕妇中阴道分娩7例,剖宫产4例;失败组10例均剖宫产分娩。21例孕妇均未发生胎盘早剥、胎膜早破、脐带脱垂、早产、急诊剖宫产,无不能耐受疼痛而终止操作者,新生儿均无低Apgar评分。结论无镇痛外倒转术可提高阴道分娩率,且无麻醉风险,操作过程可耐受。

Objective To explore the safety and related factors of the operation of external inversion for the late parturient with single breech presentation.Methods From September 2017 to March 2019,21 pregnant women who were examined regularly in our hospital and diagnosed singleton breech position in the third trimester of pregnancy and were willing to perform external reversal operation were selected as the subjects,and non-analgesia reversal operation was performed.The patients were divided into two groups:the successful group and the failed group.The success rate of the external reversal was calculated,the factors influencing the success of the external reversal were discussed.The clinical data of the two groups were compared,the outcome of pregnancy was followed up and the complications of external inversion were analyzed.Results Among the 21 cases,11 were successful(52.4%)and 10 failed(47.6%).There was no significant difference in the success rate of the external inversion between the two groups(P>0.05).In the successful group,there were 7 cases of vaginal delivery,4 cases of cesarean section and 10 cases of failure group.All of the 21 pregnant women did not have placental abruption,premature rupture of membranes,umbilical cord prolapse,preterm delivery,emergency cesarean section,no intolerable pain to terminate the operator,and no newborn had low Apgar score.Conclusion The operation without analgesia can improve the rate of vaginal delivery and reduce the rate of cesarean section,and there is no anesthetic risk,and the operation process can be tolerated.