胎头高直位92例分析及体会  

Clinical Analysis of 92 Cases Complicated with Sincipital Position

作　　者：李白鸾[1] 吕群英[1] 倪仁敏[1] 

机构地区：[1]昆明医学院第一附属医院妇产科,昆明650032

出　　处：《昆明医学院学报》2005年第1期53-55,共3页Journal of Kunming Medical College

摘　　要：目的 :探讨胎头高直位的诊断及处理 .方法 :对 92例高直位病例进行回顾性分析 .结果 :高直后位 84例 ,高直前位 8例 .产程特点 :临产后胎头不入盆 82例 ,占 89% ;原发性及继发性宫缩乏力 6 5例 ,占71% ;潜伏期延长 85例 ;92例中有 30例未进入活跃期 ,6 2例进入活跃期者 2 9例活跃期延长 ,33例活跃期停滞 .胎膜早破 19例 ,占 2 0 .8% .妊娠结局 :87例 (94 . 6 % )剖宫产 ,5例 (5. 4 % )经手指旋转胎头变为枕位后经阴道分娩 .无一例发生新生儿窒息、子宫破裂和产后出血 .结论 :高直位是分娩难度很大、剖宫产率极高的严重胎位异常 ,但只要严密观察产程 ,及时发现并进行手指旋转胎头 ,仍有部分病例可转为枕位而经阴道分娩并避免母婴损伤 .Objective: To study the diagnosis and treatment of sincipital position.Methods: 92 cases presented sinciputal were retrospectively analyzed.Results: 92 cases of presented sincipital were diagnosed including 84 cases of occipitosacral position and 8 cases of occipitopubic position.Characteristics of labor stages were analyzed.82 cases didn't engage even in labor, accounting for 89%.Uterine atony both primary or secondary in 65 cases, accounting for 71%.Prolonged latent phase in 85 cases.30 cases didn't enter active phase and 62 cases enter active phase but in which 29 cases had prolonged active phase and 33 cases had protracted active phase.19 cases complicated with preterm rupture of membrane, accounting for 20.8%.87 cases in cesarean section.5 cases delivered vaginally by manual rotation to occiput position.No neonatal asphyxia, uterine rupture and postpartum hemorrhage occurred in all cases.Conclusion: Sincipial position is a severe abnormal position which is very difficult to deliver by vagina and has a very high risk of cesarean section.But if we can keep watch on the labor stages carefully and diagnose it timely, then partial cases have chance to deliver per vagina by manual rotation to occiput position without trauma both mothers and infants.

关 键 词：旋转胎头 活跃期 经阴道分娩 诊断 手指 体会 产程特点 难度 结论 目的 

分 类 号：R714[医药卫生—妇产科学] R719[医药卫生—临床医学]