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目的:探讨初产妇分娩异常与肩难产的关系。方法:选择2000～2008年以单胎、头位、初次分娩时发生肩难产的29例初产妇为研究组,随机选择同期条件与研究组相匹配的108例初产妇作为对照组,比较两组巨大儿的发生率、顺产及阴道助产比率、活跃期宫颈扩张速率及第一、第二产程的持续时间。结果:与对照组相比,研究组巨大儿发生率、子宫收缩乏力明显增加(P<0.05),第一产程减速期及第二产程时限明显延长(P<0.05),阴道手术助产的比率增加(P<0.01)。结论:初产妇分娩巨大胎儿、第二产程延长超过2 h及阴道手术助产均与肩难产有关。
Objective: To investigate the relationship between abnormal labor and shoulder dystocia in primipara. Methods: A total of 29 primiparous women with single shoulder, head position and initial labor were selected as study group from 2000 to 2008, and 108 primiparous women, who were matched with the study group at the same period, were randomly selected as the control group. The incidence of macrosomia, birth and vaginal midwifery ratio, the rate of cervical dilation during the active phase and the duration of the first and second stage of labor. Results: Compared with the control group, the incidence of macrosomia, uterine atresia and fatigue in the study group were significantly increased (P <0.05), and the deceleration phase of the first stage of labor and the duration of the second stage of labor were significantly prolonged (P <0.05) Increase (P <0.01). CONCLUSIONS: The first fetus gives birth to a huge fetus, the second stage of labor prolongs for more than 2 hours, and vaginal delivery is associated with shoulder dystocia.