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目的:探讨第二产程中胎方位对分娩方式和母儿病率的影响。方法:采用回顾性分析方法,在2003年1月～2007年11月住院分娩的10 498例第二产程的分娩资料中,选择初产妇、单胎、足月妊娠、无明显头盆不称、无妊高征等妊娠并发症或合并症的持续性枕后位128例(枕后位组)、持续性枕横位104例(枕横位组)为研究对象,选择同期枕前位产妇130例做为对照组(枕前位组),选择条件同枕后位组。比较3组产程情况、分娩方式及母儿结局。结果:与枕前位组相比,枕后位组第一产程、第二产程及总产程时间均延长,差异有显著性意义(P<0.05);枕横位组与枕前位组比较第二产程差异有显著性意义(P<0.05)。与枕前位组比较,枕后(横)位组产钳助产、剖宫产、会阴裂伤、产后出血、缩宫素使用、胎儿窘迫等均明显高于枕前位组,差异均有显著性意义(P<0.05)。结论:胎方位异常可导致产程延长和母儿并发症增加,正确认识、及时处理枕后(横)位对改善分娩结局、减少母儿并发症具有重要意义。
Objective: To investigate the effect of fetal position in the second stage of labor on delivery mode and maternal and child morbidity. Methods: A retrospective analysis method was used to select primipara, singleton and full-term pregnancy in 10 498 second-stage delivery materials hospitalized in hospital from January 2003 to November 2007, No pregnancy-induced hypertension and other complications of pregnancy or complications of persistent posterior occiput posterior 128 cases (posterior occiput), continuous occipital transverse 104 cases (occipital transection) as the study object, select the same period before the pillow maternal 130 Example as a control group (pillow anterior group), the choice of conditions with the occiput posterior group. Compare the three groups of labor conditions, mode of delivery and maternal and child outcomes. Results: Compared with the anterior occipital group, the duration of the first stage of labor, the second stage of labor and the total stage of labor were longer in the occiput posterior group, with significant difference (P <0.05). Compared with the anterior occipital group There was a significant difference in the second stage of labor (P <0.05). Compared with the anterior occiput, occipital posterior (horizontal) bit forceps midwifery, cesarean section, perineal laceration, postpartum hemorrhage, oxytocin use, fetal distress were significantly higher than the anterior occipital group, the difference was significant Sexual significance (P <0.05). Conclusion: Abnormal fetal position can lead to prolonged labor and increased complications of mother and child. Correct understanding and timely treatment of occiput posterior (transverse) position is of great significance to improve delivery outcomes and reduce complications of both mother and child.