产钳保留原位方法娩出胎头且会阴不侧切母婴结局分析  

Effect of in Situ Delivery of Fetal Head by Forceps Preservation on Delivery Outcomes of Parturients without Lateral Episiotomy

作　　者：孙立琴[1] 范裕如[1] 李六兰 樊雪梅 王瑶[1] 周春秀[1] SUN Liqin;FAN Yuru;LI Liulan(Department of Obstetrical,Women′s Hospital of Nanjing Medical University,Nanjing Jiangsu 210004,China)

机构地区：[1]南京医科大学附属妇产医院产科,江苏南京210004

出　　处：《实用妇产科杂志》2024年第4期302-305,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨在低位产钳助产中,采用产钳保留原位方法娩出胎头且会阴不侧切对产妇和新生儿结局的影响。方法:选择2021年1月至2023年4月在南京医科大学附属妇产医院经阴道分娩行低位产钳术且会阴不侧切产妇63例进行回顾性分析,依据取出产钳时间不同分为产钳保留原位方法娩出胎头组(观察组,37例)和提早取出产钳方法娩出胎头组(对照组,26例),比较两组产妇和新生儿结局差异。结果:两组产妇均无肩难产和会阴Ⅳ度裂伤。两组的会阴裂伤程度、阴道裂伤、阴道血肿、子宫颈裂伤、产后出血分娩并发症比较,差异均无统计学意义(P>0.05)。两组产妇全部活产,产钳助产至胎儿娩出时间比较差异无统计学意义(P>0.05)。两组新生儿均无重度窒息、颅内出血和死亡,新生儿钳痕、颜面部擦伤和轻度窒息占比差异均无统计学意义(P>0.05)。结论:产钳保留原位较提早取出产钳方法娩出胎头应用于会阴不侧切,不增加会阴损伤,不增加相关母婴并发症,是一项实用且安全的临床技术。Objective:To investigate the effect of forceps retention in situ delivery of fetal head without lateral episiotomy on maternal and neonatal outcomes during low forceps delivery.Methods:From January 2021 to April 2023,63 puerperas who underwent low forceps delivery during vaginal birth without lateral episiotomy in Women′s Hospital of Nanjing Medical University were selected for retrospective analysis.According to the different time of forceps removal,they were divided into the observation group(n=37)and the control group(n=26).Maternal and neonatal outcomes were compared between the two groups.Results:There was no shoulder dystocia or perineal laceration ofⅣdegree in either group.There was no significant difference in the degree of perineal laceration,vaginal laceration,vaginal hematoma,cervical laceration or postpartum hemorrhage between the two groups(P>0.05).All mothers in both groups delivered live infants,and there was no significant difference in the time from forceps application to fetal delivery between the two groups(P>0.05).There were no cases of severe asphyxia,intracranial hemorrhage or death in the two groups,and there were no significant differences in the proportion of neonatal forceps marks,facial abrasions and mild asphyxia(P>0.05).Conclusions:It is a practical and safe clinical technique to retain forceps in situ for delivery of the fetal head during low forceps delivery without episiotmy,without increasing perineal injury and related maternal and neonatal complications.

关 键 词：低位产钳术 产钳保留原位娩出胎头 限制性会阴切开 无创分娩 

分 类 号：R719.6[医药卫生—妇产科学]