不同娩头手法对胎头深陷行剖宫产术后母婴结局的影响

Effect of different methods of delivering head on maternal and infant outcomes after cesarean section with deep fetal head depression

目的探究不同娩头手法对胎头深陷行剖宫产术后母婴结局的影响。方法选取2020年7月至2022年8月鹰潭市妇幼保健院收治的60例急诊单胎头位深陷而试产失败行剖宫产孕妇作为研究对象,采用随机数字表法将其分为观察组(n=20)、对照1组(n=20)和对照2组(n=20)。观察组采用头低位行阴道上推胎头后切开子宫,对照1组采用头低位行阴道上推胎头前切开子宫,对照2组采用改臀牵组。比较三组围手术期指标、术后并发症和新生儿体征指数。结果观察组产妇的剖宫产手术时间和住院时间均短于对照1组和对照2组,术中出血量少于对照1组和对照2组,差异有统计学意义(P<0.05)。剖宫产分娩结束3 d内,观察组产妇的术后并发症发生率与新生儿术后并发症发病率均低于对照1组和对照2组,差异有统计学意义(P<0.017)。分娩后,三组新生儿的出生体重比较,差异无统计学意义(P>0.05)。观察组新生儿的Apgar评分高于对照1组和对照2组,差异有统计学意义(P<0.05)。结论对于急诊单胎头位深陷试产失败而行剖宫产临床分娩,头低位行上推胎头后切开子宫的娩头手法能够有效降低术后母婴不良结局的发生风险,同时改善产妇围手术期指标,进而促进其术后恢复与母婴健康,临床应用价值较高。

Objective To explore the influence of different head delivery methods on maternal and infant outcomes after cesarean section with deep fetal head.Methods From July 2020 to August 2022 in Yingtan Maternal and Child Health Hospital,60 pregnant women who underwent cesarean section due to the failure of trial delivery were selected as the research object.They were divided into observation group(n=20),control group 1(n=20)and control group 2(n=20)by random number table method.The observation group was treated with pushing the fetal head on the vagina and then cutting the uterus,while the control group 1 was treated with the same method.Results The time of cesarean section and hospitalization in the observation group were shorter than those in the control group 1 and the control group 2,and the amount of bleeding during operation was less than that in the control group 1 and the control group 2,with statistical significance(P<0.05).Within 3 days after delivery by cesarean section,the incidence of postoperative complications in the observation group was lower than that in the control group 1 and the control group 2,with statistical significance(P<0.017).After delivery,there was no significant difference in birth weight between the three groups(P>0.05).The Apgar score of newborns in the observation group was higher than that in the control group 1 and the control group 2,with significant difference(P<0.05).Conclusion For the clinical delivery of emergency singleton with head position falling into trial delivery failure and undergoing cesarean section,the head delivery method of pushing the fetal head downwards and then cutting the uterus can effectively reduce the risk of adverse maternal and infant outcomes after operation,and improve the perioperative indicators of the parturient,thus promoting their postoperative recovery and maternal and infant health,which has high clinical application value.