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目的:探讨徒手转胎位处理头位难产的疗效。方法:收集2008年8月～2011年3月215例头位难产产妇,其中119例患者持续性枕横位,81例患者持续性枕后位,其余15例患者为前不均倾位、胎头高直位、颜面位、额位等,使用徒手转胎位处理持续性枕横位、持续性枕后位导致的头位难产产妇,观察徒手转胎位处理头位难产的效果。结果:①119例持续性枕横位,徒手转胎位成功102例,成功率为85.7%。其余17例产妇因产程阻滞、胎儿宫内窘迫而行胎头吸引术或剖宫产术。81例持续性枕后位,徒手转胎位成功68例,成功率为84.0%。其余13例产妇因产程阻滞、胎儿宫内窘迫而行胎头吸引术或剖宫产术。两组患者的徒手转胎位成功率差异无统计学意义(χ2=0.117 6,P=0.737 4)。②170例经徒手转胎位而出生的新生儿出生情况良好,166例新生儿Apgar评分≥7分,余4例新生儿<7分,但经吸氧处理后,Apgar评分转为正常。结论:徒手转胎位是纠正持续性枕横位、持续性枕后位所致头位难产的有效方法。
Objective: To investigate the effect of uncooperative hand position in treating head dystocia. Methods: From August 2008 to March 2011, 215 cases of headpartum dystocia, including 119 cases of continuous occipital transverse position, 81 cases of persistent occiput posterior position, and the remaining 15 cases were anterior disparity, fetal Head straight position, face position, forehead, etc., the use of manual transfer of fetal position to treat persistent occipital transverse position, persistent occiput posterior position of the first bit of labor in maternal obstetrics and gynecology, the first hand to observe the transfer of the first bit of labor to address the effect of dystocia. Results: ① In 119 cases of continuous occipital transverse position, 102 cases were successful in hand position transfer. The success rate was 85.7%. The remaining 17 cases of labor due to labor block, fetus fetal distress and fetal head or cesarean section. Eighty-one cases of persistent posterior occiput posterior, hand-transfer to the position of success in 68 cases, the success rate was 84.0%. The remaining 13 cases of labor due to labor block, fetus fetal distress and fetal head or cesarean section. There was no significant difference between the two groups in the success rate of manual hand-transfer (χ2 = 0.117 6, P = 0.737 4). ② The birth of 170 newborns who had been manually transferred to the fetus was well-born. The Apgar score of 166 newborns was ≥7 and the remaining four neonates were <7. However, Apgar score turned to normal after oxygen treatment. Conclusion: Manual rotation of the fetal position is to correct the continuous occipital transverse position, persistent posterior position caused by an effective method of dystocia.