【摘要】 目的:探讨第二产程中胎方位对分娩方式和母儿病率的影响。方法:采用回顾性分析方法,在2003年1月～2007年11月住院分娩的10 498例第二产程的分娩资料中,选择初产妇、单胎、足月妊娠、无明显头盆不称、无妊高征等妊娠并发症或合并症的持续性枕后位128例(枕后位组)、持续性枕横位104例(枕横位组)为研究对象,选择同期枕前位产妇130例做为对照组(枕前位组),选择条件同枕后位组。比较3组产程情况、分娩方式及母儿结局。结果:与枕前位组相比,枕后位组第一产程、第二产程及总产程时间均延长,差异有显著性意义(P<0.05);枕横位组与枕前位组比较第二产程差异有显著性意义(P<0.05)。与枕前位组比较,枕后(横)位组产钳助产、剖宫产、会阴裂伤、产后出血、缩宫素使用、胎儿窘迫等均明显高于枕前位组,差异均有显著性意义(P<0.05)。结论:胎方位异常可导致产程延长和母儿并发症增加,正确认识、及时处理枕后(横)位对改善分娩结局、减少母儿并发症具有重要意义。更多还原

【Abstract】 Objective:To explore the effect of fetal position at second stage of labor on delivery modes and maternal and neonatal morbidities.Methods:The data of second stage of labor of 10 498 lying-in women from January 2003 to November 2007 were analysed retrospectively,128 lying-in women with persistent occipitoposterior position(occipitoposterior position group) and 104 lying-in women with persistent occipitotransverse position(occipitotransverse position group) were selected,and all the women were single birth,primipara,full-term pregnancy,excluding pregnant complications such as cephalopelvic disproportion and hypertensive disorder complicating pregnancy,and 130 lying-in women with occipito-anterior position were selected as control group.The birth process,delivery modes and outcomes of mothers and infants were compared among 3 groups.Results:The duration times of first,second and total stage of labor in occipitoposterior position group were longer than those in control group(P<0.05);there was significant difference in duration of second stage of labor between occipitotransverse position group and control group(P<0.05).The rates of midwifery,cesarean section,perineal laceration,postpartum hemorrhage,oxytocin usage and fetal distress in occipitoposterior position group and occipitotransverse position group were higher than those in control group(P<0.05).Conclusion:Fetal malposition may prolong labor and increase complications of mothers and infants,correct diagnosis and timely treatment are vital for improvement of labor outcomes and decreasing complications of mothers and infants.更多还原