【摘要】 本文对产程进入活跃期后枕后位52例经加强产力、改变母体体位、封闭水肿宫颈等处理,胎方位仍不能自然旋转为枕前位,产程阻滞的持续性枕后位(POPP)施行经阴道徒手旋转儿头,辅以经孕妇腹部推儿背为脊前方位联合手法。结果表明本法可矫正POPP为枕前位(OA),改善胎头俯屈降低难产发生,成功率达76.9%。本文提示,头位分娩评分与徒手旋转成功有相关性,轻微头盆不称即头盆评分6～7分者,与头盆关系正常≥8分者两组间无明显差异(x~2=0.26 P>0.05);而四项评分高低对徒手旋转成败有显著影响(x~2=28.23 P<0.01)。关键在于由枕后位(OP)1分增加到OA3分,使四项评分均达11分以上,绝大多数(80%)可经阴道分娩。更多还原

【Abstract】 52 cases of POPP were retrospectively analysed in this study. Each POPP obstructed labor was treated by manual rotation of fetal head from OP to OA position through vagina and in the meantime pushing fetal back to spine-forward position on maternal abdomen in active phase of labor after failure of correcting fetal head position by several treatments, such as enhancing uterine contraction, changing maternal body position and injecting xylocaine in swelled cervix. The successful rate of manual rotation was 76.9%. We concluded that it was an efficient way to decrease difficult labor when fetal head position was abnormal. The study also demonstrated the relation of the successful manual rotation of fetal head to the score of cephalic presentation delivery. Slight head-pelvis asynergy means that the score of head-pelvis is 6—7 point and the score is or is over 8 point means there is not head-pelvis asynergy. The difference between the above two groups was not obvious (P>0.05), The resuits of the score of four items might obviously influence whether the manual rotation was successful (P<0. 01). If the OP’s one point was changed into OA’s three point and the scores of the 4 items were all over 11 point, the maiority cases (80%) might give birth through vagina.更多还原