产钳助娩术43例分析

目的分析产钳助娩术在头位难产中的应用价值。方法对笔者所在医院2007年9月至2009年2月产钳助娩术43例临床资料进行回顾性分析。结果产钳术母体并发症发生16例,发生率37.2%;产钳术新生儿并发症发生8例,发生率18.6%。结论适当的产钳助娩术能有效的解决一部分难产问题,是降低剖宫产率的有力措施之一。

利用抗生素预防产钳助娩后母体感染的研究

目的探讨在产钳助娩的产妇中进行预防性抗生素的使用,并分析其对于产妇产后母体感染的影响。方法选择2016年1月至2018年1月在慈林医院妇产科分娩、并由于第二产程延长而进行产钳助娩的产妇共计186例。随机分为A组(研究1组)、B组(研究2组)和C组(对照组),每组各有62人。A组研究对象:对产妇在进行产钳娩前0.5小时进行头孢类广谱抗生素的应用,并在产钳助娩后12小时追加1次抗生素的应用。B组研究对象:产妇在进行产钳娩后连续3天使用头孢类广谱抗生素进行预防。C组研究对象:产妇在产钳助娩前后不进行预防性抗生素的使用。观察三组产妇产后母体感染的差异,并分析结果。结果三组产妇产后两天最高体温比较有显著性差异(F=11.42,P<0.05),血象异常、母体产后感染发生率比较有显著性差异(χ2值分别为6.10、8.27,均P<0.05),进一步两组间比较,结果显示C组显著高于A组和B组(t值分别为4.95、5.03,χ2值分别为5.15、8.05、5.90、4.21,均P<0.05),而A组与B组比较无显著性差异(t=2.94,χ2值分别为0.54、0.21,均P>0.05)。三组产后平均住院天数组间比较有显著性差异(F=10.67,P<0.01),其中C组大于A组和B组(t值分别为4.95、5.03,均P<0.05),而A组与B组比较无显著性差异(t=2.84,P=0.31>0.05)。结论合理的抗生素使用可以预防产钳助娩后母体感染,具有临床推广意义。

剖宫产术应用小产钳助娩的临床观察

目的探讨剖宫产术中应用小产钳助娩的方法及临床效果。方法将2009年12月至2010年12月在高州市妇幼保健院行剖宫产术中估计胎头娩出困难时应用小产钳助娩的362例产妇为观察组(小产钳助娩),随机取2008年12月至2009年12月在高州市妇幼保健院行剖宫产术中估计胎头娩出困难的331例产妇为对照组(手娩),对两组的手术效果进行比较。结果两组从子宫切开至胎儿娩出的时间比较差异有显著性(P<0.01),两组术中出血量及住院时间比较差异均无显著性(P>0.05),两组的新生儿窒息率及颅内出血率比较差异有显著性(P<0.01),两组产妇子宫切口撕裂的发生率比较差异具有显著性(P<0.01)。结论在剖宫产术中胎头娩出困难时应用小产钳助娩,能够促进胎儿的顺利娩出,有效减少术后新生儿及产妇并发症的出现,值得临床推广运用。

剖宫产术中使用小产钳助娩90例临床分析

剖宫产虽被视为较安全的手术,但也蕴藏着诸多不安全因素,如新生儿窒息、新生儿创伤、子宫下段裂伤、膀胱损伤等.胎头娩出是剖宫产术的关键步骤,如遇娩头困难,应及时助产,使胎儿迅速娩出,以减少母婴并发症.我院2008年6 月至2010 年6 月收治剖宫产术中使用小产钳助娩90例,现回顾性分析其临产的应用效果,报道如下：

头位剖宫产应用产钳助娩胎头110例临床分析

现对我院7年间在剖宫产手术中应用产钳助娩胎头的110例患者的临床资料进行回顾性分析,并就如何正确使用产钳助娩胎头进行探讨,指出头位剖宫产手术中使用产钳助娩胎头是解决娩头困难的有效手段。

无侧切低位产钳助娩在阴道分娩中的应用

目的本文探讨无侧切的低位产钳助娩在阴道分娩头位难产中的应用。方法对我院产科于2016年6月至2017年3月期间采用无侧切低位产钳助娩的57例产妇临床资料进行回顾性的析。结果57例产钳助娩全部成功,平均牵拉1~2次宫缩,最多不超过3次宫缩;新生儿无窒息、出生后1 min Apgar评8分2例(其中1例为羊水Ⅲ度、胎儿窘迫,另1例为IUGR)、5 min Apgar评9分;55例1 min Apgar评9分;无肩难产、无新生儿死亡和颅内出血、有轻微的皮肤压痕、无皮肤破损和头皮血肿;会阴无裂伤者10例,会阴体Ⅰ度裂伤者43例(其中的2例合并有阴道壁的裂伤),会阴体Ⅱ度裂伤者4例,无会阴体Ⅲ度和Ⅳ裂伤;产后出血2例。结论无侧切的低位产钳助娩操不只作流程简单,更重要的是减少了母婴并发症,相对于侧切的产妇产后恢复更快,从而利于降低剖宫产率,值得临床上广泛学习和推广。

单叶小产钳在新式剖宫产术中助娩胎头高浮的应用体会

新式剖宫产已成为剖宫产术的主导术式。但是它的缺点之一是因腹壁切口、子宫下段切口位置低造成娩头困难。难免延长胎头娩出时间及增加新生儿、孕产妇并发症。我们尝试剖宫产术中应用单叶小产钳助娩高浮胎头有助于迅速娩出胎儿,有效地减少了术中的取头困难及并发症,明显减少切开子宫至胎儿娩出的时间间隔（U-DI）,减少新生儿窒息的发生,是产科医师应当熟练掌握的技术,

社区剖宫产单叶产钳助娩一例报告

患者,女,28岁,回族,住院号41077。因＂孕2产1孕足月,无腹痛＂,于2017年3月28日来院,门诊以＂孕2产1宫内妊娠孕足月头位、前次剖宫产、瘢痕子宫＂收住入院。入院查体：T：36℃,P：80min^-1,R：20min^-1,BP：106mmHg/66mmHg,神志清,精神好。心肺听诊无明显异常。

产钳和负压吸引助娩对于产妇和新生儿的即刻效应

OBJECTIVE: To estimate the differences in immediate maternal and neonatal effects of forceps and vacuum-assisted deliveries. METHODS: We conducted a medical record review of all forceps and vacuum-assisted deliveries that occurred from January 1, 1998, to August 30, 1999, at Winthrop-University Hospital. Maternal demographics and delivery characteristics were recorded. Maternal outcomes, such as use of episiotomy and presence of lacerations, were studied. Neonatal outcomes evaluated were Apgar scores, neonatal intensive care unit admissions, cephalohematomas, instrument marks and bruising, and caput and molding. RESULTS: Of 508 operative vaginal deliveries, 200 were forceps and 308 were vacuum assisted. Forceps were used more often than vacuum for prolonged second stage of labor (P = .001). There was a higher rate of epidural (P = .02) and pudendal(P < .001) anesthesia, episiotomies (P = .01), maternal third-and fourth-degree perineal (P < .001) and vaginal lacerations (P = .004) with the use of forceps, whereas periurethral lacerations were more common in vacuum-assisted (P = .026) deliveries. More instrument marks and bruising (P < .001) were found in the neonates delivered by forceps, whereas there was a greater incidence of cephalohematomas (P = .03) and caput and molding (P < .001) in the neonates delivered with vacuum. Multivariable logistic regression analysis showed that forceps use was associated with an increase in major perineal and vaginal tears (odds ratio [OR] 1.85; 95%confidence interval [CI] 1.27, 2.69; P = .001), an increase in instrument marks and bruising (OR 4.63; 95%CI 2.90, 7.41; P < .001) and a decrease in cephalohematomas (OR 0.49; 95%CI 0.29, 0.83; P = .007) compared with the vacuum. CONCLUSIONS: Maternal injuries are more common with the use of forceps. Neonates delivered with forceps have more facial injuries, whereas neonates delivered with vacuum have more cephalohematomas.

手术助产的阴道分娩所致新生儿和婴儿的不良结果:人群回顾性分析

Objective: To compare the risk of neonatal and infant adverse outcomes between vacuum and forceps assisted deliveries. Design: Population based study. Setting: US linked natality and mortality birth cohort file and the New Jersey linked natality, mortality, and hospital discharge summary birth cohort file. Participants: Singleton livebirths in the United States (n = 11 639 388) and New Jersey (n = 375 351). Main outcome measures: Neonatal morbidity and mortality. Results: Neonatal mortality was comparable between vacuum and forceps deliveries in US births (odds ratio 0.94, 95%confidence interval 0.79 to 1.12). Vacuum delivery was associated with a lower risk of birth injuries (0.69, 0.66 to 0.72), neonatal seizures (0.78, 0.68 to 0.90), and assisted ventilation (< 30 minutes 0.94, 0.92 to 0.97; ≥30 minutes 0.92, 0.88 to 0.98). Among births in New Jersey, vacuum extraction was more likely than forceps to be complicated by postpartum haemorrhage (1.22, 1.07 to 1.39) and shoulder dystocia (2.00, 1.62 to 2.48). The risks of intracranial haemorrhage, difficulty with feeding, and retinal haemorrhage were comparable between both modes of delivery.Sequential use of vacuum and forceps was associated with an increased risk of need for mechanical ventilation in the infant and third and fourth degree perineal tears. Conclusion: Although vacuum extraction does have risks,it remains a safe alternative to forceps delivery.

双叶产钳在肥胖产妇胎头高浮剖宫产术中的应用

近年来，我国肥胖产妇逐年增加，剖宫产术中胎头高浮现象增多见，造成徒手娩出胎头困难。2009年1月～2011年10月，我院在肥胖产妇胎头高浮剖宫产术中用双叶产钳助娩，取得了良好效果。现报告如下。

重度妊娠高血压综合征分娩方式的选择

目的:探讨重度妊娠高血压综合征(妊高征)分娩方式的选择。方法:对132例重度妊高征患者采取不同的分娩方式观察临床效果。其中剖宫产术78例,占59.1%;会阴侧切产钳助娩44例,占33.3%;催产素引产和自然分娩者10例,占7.6%;结果:死亡3例,占2.3%,胎儿及新生儿死亡共4例,占围产儿死亡的3.79%。结论:对重度妊娠高血压综合征要积极防治,适时终止妊娠。