胎头位置异常、胎儿巨大与自然分娩初产妇头位难产的关系分析  

Association analysis of abnormal fetal head position,fetal macrosis and head dystocia in natural labor for primiparous mothers

作　　者：姚军娥 李秀芳 耿平 YAO Jun'e;LI Xiufang;GENG Ping(Department of Obstetrics,Dongchangfu Campus,Liaocheng People's Hospital,Liaocheng,Shandong,252000,China)

机构地区：[1]聊城市人民医院东昌府院区产科,山东聊城252000

出　　处：《当代医学》2022年第30期67-70,共4页Contemporary Medicine

摘　　要：目的探究胎头位置异常、胎儿巨大与自然分娩初产妇头位难产的关系。方法回顾性分析2019年1月至2021年1月于本院妇产科就诊并分娩的234例孕产妇的临床资料,统计孕产妇生产前最后一次产检内容及头位分娩评分,评估产妇是否出现头位难产情况;统计生产过程中出现头位难产情况(初产妇的怀孕次数、羊水量、胎儿的具体情况),分析其发生头位难产的因素。结果234例产妇中共发生41例头位难产情况,占比17.6%;单因素及多因素Logistic回归分析显示,胎儿体质量≥4000 g、胎头位置为枕横位或枕后位、产妇产力评分<3分及产妇生产时羊水量>2000 ml或<500 ml均为产妇头位难产的影响因素(P<0.05)。结论胎儿体质量≥4000 g、胎头位置为枕横位或枕后位、产妇产力评分<3分及产妇生产时羊水量>2000 ml或<500 ml均为产妇出现头位难产的危险因素,临床应根据上述危险因素,及时做好急救准备,合理选择分娩方式,帮助产妇顺利生产。Objective To investigate the association between abnormal fetal head position,fetal giganticism and head dystocia in the first time of spontaneous delivery.Methods The clinical data of 234 pregnant women who attended and delivered in the Department of Obstetrics and Gynecology of our hospital from January 2019 to January 2021 were retrospectively analyzed,and the contents of the last prenatal examination and the score of cephalic delivery were counted,whether the women had cephalic dystocia were evaluated.The occurrence of cephalic dystocia(the number of pregnancies of the new mother,the amount of amniotic fluid,the specific situation of the fetus)during the birth process were calculate,and the factors of cephalic dystocia were analyzed.Results Among 234 women,a total of 41 cases of cephalic dystocia occurred,accounting for 17.6%.Univariate and multivariate Logistic regression analysis showed that fetal body weight≥4000 g,fetal head position in occipital transverse or posterior occipital position,maternal productivity score<3 scores,and amniotic fluid volume>2000 ml or<500 ml at the time of delivery were the influencing factors of maternal head dystocia(P<0.05).Conclusion Fetal body weight≥4000 g,fetal head position in occipital transverse or posterior occipital position,maternal productivity score<3 scores,and amniotic fluid volume>2000 ml or<500 ml at the time of delivery are all risk factors for maternal head dystocia.

关 键 词：初产妇 头位难产 关联性分析 

分 类 号：R714.4[医药卫生—妇产科学]