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目的探讨头位难产中通过体位改变配合徒手矫正胎方位在难产中的实用价值。方法 2008年1月至2008年12月在我院住院分娩的产妇共2 598例,随机选取其中持续性枕横位或枕后位导致头位难产的产妇216例,根据其产科指征和干预时机分3组,采用体位改变配合徒手矫正胎方位,分析其分娩结局。结果 216例产妇通过体位改变矫正胎方位22例,配合徒手矫正胎方位成功169例,成功率为88.43%。成功者均阴道分娩,失败者均剖宫产终止妊娠。无一例出现胎盘早剥、脐带脱垂、胎儿头皮血肿、颅内出血、新生儿重度窒息等并发症。结论适时体位改变配合徒手矫正胎方位能增加阴道分娩率,降低剖宫产率。
Objective To investigate the practical value of head-position dystocia in difficult-to-deliver labor by changing body position with uncooperative fetus. Methods From January 2008 to December 2008, a total of 2 598 pregnant women were hospitalized in our hospital. Among them, 216 maternal mothers with persistent occipital transverse position or occiput posterior position were randomly selected. According to their obstetric indications and interventions The timing is divided into 3 groups, with the position changes with bare hands to correct fetal position, analyze the delivery outcome. Results Totally 216 maternal mothers were corrected by position changes. Totally, 22 cases were corrected with fetal position, and 169 cases were successfully corrected with bare hands. The success rate was 88.43%. Winners were vaginal delivery, losers were cesarean termination of pregnancy. No case of placental abruption, umbilical cord prolapse, fetal scalp hematoma, intracranial hemorrhage, neonatal complications such as severe asphyxia. Conclusion The timely change of position combined with free hand correction of fetal position can increase the vaginal delivery rate and reduce the rate of cesarean section.