胎儿体重对持续性枕后位产程特征和分娩结局影响的分析

目的:探讨胎儿体重对持续性枕后位产程特征和分娩结局的影响.方法:对2005年12月至2009年12月在本院产科住院分娩228例持续性枕后位产妇的临床资料进行回顾性分析,根据新生儿出生体重分为对照组112例(胎儿体重≥2500 g且＜3500 g)和研究组116例(胎儿体重≥3500 g且＜4250 g).并将两组产程特征、母儿结局进行分析比较.结果:两组产妇产程异常(宫口扩张延缓、停滞,胎头下降延缓、停滞)发生率、临床干预(体位矫正、手转胎头)成功率、剖宫产率、母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率差异均有统计学意义(P＜0.05).结论:持续性枕后位产程处理中充分考虑胎儿的体重因素,对于胎儿估计体重≥3500 g的枕后位病例应积极临床干预,干预失败应放宽手术指征,以降低母儿并发症发生率.

Clinical Analysis of the Effect of Fetal Weight on Persistent Occiput Posterior Position and Delivery Outcomes

Objective:To investigate the effect of fetal weight on clinical characteristics and delivery outcomes on persistent occiput posterior position .Methods:228 cases of persistent occiput posterior position from Dec.2005 to Dec.2009 in Zhengzhou People′s Hospital were analyzed retrospectively. According to the birth weight , these patients were divided into control group (112 cases, 2500 g ≤birth weight≤ 3500 g) and study Group (116 cases, 3500 g ≤birth weight<4250 g). The clinical features of labor process and maternal baby outcomes in the two groups were analyzed. Results:The rates of abnormal labor process (delayed cervical dilation and stagnation, delayed descendence of fetal head and stagnation), the successful rates of clinical interventions (postural correction, manual turnover of fetal head), the cesarean section rate, the incidence of maternal and neonatal complications (postpartum hemorrhage,puerperal morbidity, fetal distress, neonatal asphyxia) were statistically significant different between the two groups (P<0.05).Conclusions:Fetal weight in persistent occiput posterior should be given more attention, especially when fetal weight ≥ 3500 g , clinical intervention should be started earlier, even adapting cesarean section to reduce the maternal and neonatal complications.