两种体侧卧位法纠正枕后位的临床观察

目的探讨产程中产妇采用两种不同体侧卧位纠正枕后位的临床效果.方法选择潜伏期经内诊或B超确诊为枕后位的初产妇100例,按随机表法分成同侧卧位组和对侧卧位组(各50例),分别采用同侧和对侧卧位法纠正胎方位,观察两组阴道分娩率、第1产程时间.结果(1)同侧卧位组阴道分娩34例(68%),胎儿转至枕前位27例(54%),对侧卧位组阴道分娩为22例(44%),胎儿转至枕前位12例(24%),两组比较,差异有显著性(P＜0.005).(2)同侧卧位组平均第1产程时间为(13.5±6.5)h;对侧卧位组平均第1产程时间为(17.1±7.2)h,两组比较,差异有极显著性(P＜0.01).结论产程中指导产妇取同侧卧位矫正枕后位,是提高阴道分娩率、缩短第1产程的有效方法.

Correction of occipito-posterior by maternal postures during the process of labor

OBJECTIVE: To investigate the effect on correction of occipito-posterior (OP) by changing maternal posture during labor. METHODS: One hundred normal primigravida with head OP position in the latent phase of labor were randomly divided into 2 groups: Group A (n = 50), women were instructed to lay on the same lateral posture with the fetal spine during labor in order to correct the fetal position from OP to occipito anterior (OA); Group B (n = 50) lay on the opposite side to the fetal spine. The OP position was diagnosed by vaginal examination or B ultrasound, and the course of labor and mode of delivery were observed. RESULTS: Thirty-four women delivered vaginally (68%) in group A, with 27 of them turned to OA position (54%); spontaneously while they were 22 (44%) and 12 (24%) in group B respectively, a significant difference was shown (P < 0.005). The average time interval for the 1st stage was (13.5 +/- 6.5) hour and (17.1 +/- 7.2) hour for group A and B respectively, also a significant difference was noted (P < 0.01). CONCLUSION: To instruct women in labor to take the lateral recumbent position with the same side of fetal spine for correcting OP to OA is an effective method. It may increase vaginal deliveries and shorten the first stage of labor, thus reduce dystocia due to OP position. This method is simple and effective, and maybe adopted in most obstetric units.