头位难产手转胎头术的时机选择

目的 探讨手转胎头术最佳时机的选择.方法 选择2010年1月至2011年12月鹿寨县中医医院收治的130头位难产产妇,根据宫口扩张大小进行手转胎术的时机分A、B、C组,对比分析三组的转位成功率、阴道分娩率、剖宫产率、新生儿出生1 min Apgar评分、阴道分娩平均时间、产后出血量等指标.结果 C组手转胎头成功率为94.5%,显著高于A组（67.4%）及B组（71.8%）;剖宫产率为5.5%,低于A组（32.6%）及B组（28.2%）;新生儿出生1 min Apgar评分为（9±1）分,优于A组的（7±2）分及B组的（7±2）分;经阴道分娩平均时间为（409±70）min,显著短于A组的（509±102）min及B组的（509±122）min;产后出血（148±56）ml,明显少于A组的（208±63）ml及B组的（213±68）ml.结论 头位难产适时给予手法旋转胎头,纠正胎头方向,可缩短产程,使胎儿顺利娩出,提高了自然分娩率,同时有效降低分娩过程中对母儿的损伤,提高产科质量.

Operative timing for manual rotation of fetal head in cephalic dystocia

Objective To investigate the operative timing for manual rotation of fetal head in cephalic dystocia. Methods One hundred and thirty pregnant women with cephalic dystocia between January 2010 and December 2011 admitted in Luzhai TCM hospital were divided into group A,B and C,according to operative timing of the dilation size of cervix for manual rotation of fetal head.The switch success rate,rate of vaginal birth,cesarean section rate,neonatal 1 minute Apgar score of neonatal,the average time of vaginal delivery and postpartum hemorrhage were comparatively analyzed among the three groups.Results The success rate of manual rotation of fetal head in group C was 94.5%,significantly higher than group A(67.4%) and group B(71.8%);The cesarean section rate was 5.5% in group C,lower than group A(32.6%) and group B(28.2%);Birth 1 minute Apgar score was(9±1)points in group C,better than group A (7±2) points]and group B (7±2)points];The average time of vaginal birth was(409±70) minutes in group C,significantly shorter than group A (509 ±102) minutes] and group B(509 ±122) minutes];Postpartum hemorrhage was(148±56) ml in group C,obviously less than group A (208+ 63)ml]and group B (213+68) ml]. Conclusion Manual rotation of fetal head for cephalic dystocia can correct fetal head direction,shorten the stages of labor,make the fetal delivery smoothly and improve the natural birth rate,at the same time,it can effectively reduce the delivery process to mother’s injury,and improve the quality of obstetrics.