肩难产的回顾性分析  

Retrospective analysis on shoulder dystocia

作　　者：胡健蓉 黄小霞[1] 张燕菲[1] 邓艳君[1] 蒋小萃 

机构地区：[1]广州市花都区妇幼保健院产科,广东广州510800

出　　处：《中国现代医生》2014年第13期118-120,共3页China Modern Doctor

摘　　要：目的探讨肩难产发生的高危因素及处理方法。方法回顾性分析我院2012年肩难产病例,根据肩难产时母婴并发症的发生率与助产手法及新生儿体重的关系进行分组,并进行分析。结果①肩难产的高危因素:新生儿体重≥3.45kg共44例,占62.0%;妊娠期糖尿病15例,占21.13%;巨大儿10例,占14.08%。②肩难产的母婴主要并发症:母体会阴裂伤28例,占39.44%,新生儿窒息5例,占7.04%。③巨大儿组的新生儿并发症发生率明显高于正常体重儿组(P<0.05)。④助产手法:采用屈大腿法成功分娩7例(9.86%),明显低于屈大腿法+压前肩法成功分娩的64例(90.14%)(P<0.05)。结论母婴并发症与新生儿体重密切相关。处理肩难产时以屈大腿法联合压前肩法为首选。Objective To discuss high-risk factors and treatment of shoulder dystocia. Methods A retrospective analy- sis was conducted on shoulder dystocia cases treated in our hospital in 2012. The cases were grouped according to the correlation between the incidence of maternal and neonatal complications during shoulder dystocia and delivery meth- ods or neonatal birth weight for further analysis. Results （1） High-risk factors of shoulder dystocia： neonatal birth weight≥ 3.45kg （44 cases, 62.0%）; gestational diabetes mellitus （15 cases, 21.13%）; macrosomia （10 cases, 14.08%）. （2） Main maternal and neonatal complications of shoulder dystocia included maternal perineal laceration（28 cases, 39.44%） and neonatal asphyxia （5 cases, 7.04%）. （3）The macrosomia group had higher incidence of neonatal complications than the normal birth weight group （P〈0.05）. （4） Delivery methods： 7 cases （9.86%） of successful delivery by mctobert ma- neuver, was fewer than 64 cases of successful delivery by mcrobert maneuver combined with suprapubic pressure （90.14%）. Conclusion Maternal and neonatal complications are closely related to neonatal birth weight, mcrobert ma- neuver combined with suprapubic pressure is the first choice for shoulder dystocia.

关 键 词：肩难产 母婴并发症 临床处理 

分 类 号：R714.44[医药卫生—妇产科学]