异常分娩中臀位助产术的临床应用效果

Clinical Application Effect of Breech Midwifery in Abnormal Delivery

目的探讨异常分娩中臀位助产术的临床应用效果。方法从2017年1月至2019年12月择取100例异常臀位产妇,以分娩方式不同为依据将其分为3组,30例实施臀位助产术产妇纳入臀位助产组,10例臀位实施牵引术产妇纳入臀位牵引组,60例实施剖宫产产妇纳入剖宫产组,对照分析3组分娩方式与围生儿体质量分布情况、围生儿并发症情况。结果从围生儿体质量情况来看,在臀位助产组中,围生儿体质量超过4000 g的产妇有1例、围生儿体质量介于3500~4000 g产妇有3例,围生儿体质量介于3000~3500 g的产妇有16例,围生儿体质量在3000 g以下的产妇有10例;在臀位牵引组中,围生儿体质量超过4000 g的产妇有0例、围生儿体质量介于3500~4000 g产妇有0例,围生儿体质量介于3000~3500g的产妇有5例,围生儿体质量在3000 g以下的产妇有5例;在剖宫产组中,围生儿体质量超过4000 g的产妇有10例、围生儿体质量介于3500~4000 g产妇有25例,围生儿体质量介于3000~3500 g的产妇有30例,围生儿体质量在3000 g以下的产妇有5例;可见围生儿体质量在3500 g以上通常多进行剖宫产,同时围生儿体质量越高越可能选择剖宫产。从围生儿并发症发生率来看,臀位助产组发生率33.33%(10例)、臀位牵引组发生率50.00%(5例)、剖宫产组发生率10.00%(6例),可见臀位牵引组围生儿并发症总发生率高于臀位助产组、剖宫产组,P<0.05。结论针对异常分娩产妇,需要综合评估母婴状况,再选择适合的助产方式,体质量在3500 g以下的胎儿适合选择臀位助产术助产,避免围生儿并发症发生。

Objective To explore the clinical application of breech midwifery in abnormal labor.Methods From January 2017 to December 2019,100 cases of abnormal breech births were selected,and they were divided into three groups based on different delivery methods.30 cases of buccal midwifery women were included in the breech midwifery group.Ten women with breech traction were included in the breech traction group,and 60 women with cesarean section were included in the cesarean section group.The three-component delivery methods and the distribution of perinatal body mass and perinatal complications were compared and analyzed.Results From the perspective of perinatal body weight,in the breech midwife group,there were 1 case of perinatal body weight exceeding 4000 g and 3 cases of perinatal body weight between 3500-4000 g.There were 16 cases of maternal weight between 3000~3500g,and 10 cases of perinatal weight less than 3000 g;in the breech traction group,there were 0 cases of perinatal weight over 4000 g.There are 0 cases of maternal weight between 3500-4000 g,5 cases of maternal weight between 3000-3500g,and 5 cases of maternal weight below 3000 g;in the cesarean section group,There are 10 cases of perinatal body weight over 4000 g,25 cases of perinatal body weight between 3500-4000 g,and 30 cases of perinatal body weight between 3000-3500 g.There are 5 cases of parturients under 3000 g;it can be seen that perinatal infants with a body mass above 3500 g usually undergo cesarean section.At the same time,the higher the perinatal infants'body mass,the more likely they are to choose cesarean section.In terms of perinatal complication rates,the incidence rate in the breech midwifery group was 33.33%(10 cases),the incidence rate in the breech traction group was 50.00%(5 cases),and the incidence rate in the cesarean section group was 10.00%(6 cases).It can be seen that the total incidence of perinatal complications in the breech traction group is higher than that in the breech midwife group and cesarean section group,P<0.05.Conclusion For women with abnormal delivery,it is necessary to comprehensively evaluate the maternal and infant status,and then choose the appropriate method of midwifery.Fetuses with a body weight of less than 3500 g are suitable to choose the breech midwifery to help delivery,to avoid perinatal complications.