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目的:探讨肩难产发生的高危因素和母婴并发症及处理方法。方法:回顾分析我院2007年7月至2012年10月16例肩难产的临床资料,分析肩难产时母婴并发症的发生率与新生儿体重、助产手法的关系。结果:肩难产的高危因素主要有巨大儿,其次为骨盆异常,过期妊娠,妊娠期糖尿病。肩难产母婴并发症主要有:母体会阴裂伤,产后出血,新生儿窒息。母亲并发症发生率与助产手法无明显关系,而新生儿并发症发生率随助产手法种类的增加而增加。结论:巨大儿是肩难产发生的首要高危因素。母体会阴裂伤、产后出血及新生儿窒息是肩难产的常见并发症。处理肩难产是以屈大腿法联合压前肩法为首选。
Objective: To investigate the risk factors of shoulder dystocia and maternal and infant complications and treatment methods. Methods: The clinical data of 16 cases of shoulder dystocia from July 2007 to October 2012 in our hospital were retrospectively analyzed. The relationship between the incidence of mother-infant complications during shoulder dystocia and body weight and midwifery was analyzed. Results: The main risk factors for shoulder dystocia were giant children, followed by pelvic anomalies, overdue pregnancy and gestational diabetes. Shoulder dystocia mother and child complications are: maternal episiotomy, postpartum hemorrhage, neonatal asphyxia. The incidence of maternal complications and midwifery practices no significant relationship, and the incidence of neonatal complications with the type of midwifery manipulation increased. Conclusion: Giant children are the most important risk factors for shoulder dystocia. Maternal episiotomy, postpartum hemorrhage and neonatal asphyxia are common complications of shoulder dystocia. Shoulder dystocia is the method of flexion and thigh leg joint pressure front shoulder method as the first choice.