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目的探讨发生头位难产的常见原因、分娩方式及产后出血、新生儿预后。方法统计分析2005年6月至2007年6月我院555例头位难产的病例,找出引起头位难产的最常见原因,探讨分娩方式,分析其预后及对新生儿的影响。结果造成头位难产的常见原因中,胎头先露方位异常355例,占64%,居第1位;产力异常引起的头位难产136例,占24.5%,居第2位;产道异常引起头位难产64例,占11.5%,位居第3位。新生儿重度窒息13例,占2.3%,新生儿死亡1例,病死率1.80‰。阴道助产分娩产后出血情况略少于剖宫产分娩。结论采用产程图与凌氏设计的头位分娩评分法有助于及时发现头位难产的病因、正确处理,为选择手术分娩的方式提供依据,从而降低剖宫产率、减少围生期母儿并发症的发生。
Objective To investigate the common causes of head dystocia, mode of delivery and postpartum hemorrhage, neonatal prognosis. Methods Statistical analysis of 555 cases of head-dystocia in our hospital from June 2005 to June 2007 were performed to find out the most common causes of head-position dystocia and explore the mode of delivery and the prognosis and the impact on newborns. Results Among the common causes of head dystocia, 355 cases (64%) belonged to the first abnormal fetal head position, 136 cases (24.5%) had head dystocia due to abnormal labor, 64 cases led to head dystocia, accounting for 11.5%, ranked No. 3. Severe asphyxia in 13 newborns, accounting for 2.3%, neonatal death in 1 case, the fatality rate of 1.80 ‰. Vaginal delivery of postpartum childbirth slightly less than cesarean delivery. Conclusions The head-to-bifurcation scoring method using labor chart and Ling’s design can help to find out the cause of head dystocia in time and provide the basis for selecting the mode of surgical delivery, so as to reduce the rate of cesarean section and reduce the incidence of perinatal maternal Complications occur.