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目的探讨肩难产的高危因素及处理方法,对肩难产进行预测、预防,尽量减少并发症的发生。方法回顾性分析肩难产36例,并随机抽取同期经阴道分娩顺产的60例作为对照。比较两组孕妇的产前、产时指标,分娩并发症及新生儿各径线、新生儿并发症的差别。结果巨大胎儿占肩难产61.1%。肩难产和顺产组的孕妇宫高、腹围及分娩并发症差异有统计学意义(P<0.01)。两组新生儿体重、身长、头围及新生儿并发症的差异有统计学意义(P<0.01)。结论巨大儿易发生肩难产,产前预测巨大儿是预防肩难产的关键。熟练掌握肩难产的各种处理方法,才能有效降低围产儿及产妇的并发症。
Objective To investigate the risk factors and treatment of shoulder dystocia, predict and prevent shoulder dystocia, and minimize the occurrence of complications. Methods Retrospective analysis of 36 cases of shoulder dystocia, and randomly selected 60 cases of vaginal delivery during the same period as a control. The differences of prenatal and obstetrical indexes, complications of childbirth and the diameter of newborn and complications of neonates were compared between the two groups. The results of a huge fetus accounted for 61.1% of shoulder dystocia. There was significant difference in uterine height, abdominal circumference and childbirth complications between the shoulder dystocia group and the cesarean section group (P <0.01). There were significant differences in body weight, length, head circumference and neonatal complications between the two groups (P <0.01). Conclusions Huge children are prone to shoulder dystocia. Prenatal gigantism is the key to preventing shoulder dystocia. Proficiency in various methods of treatment of shoulder dystocia in order to effectively reduce the complications of perinatal and maternal.