产钳在再次剖宫产协助胎头娩出的应用

目的：探讨产钳在再次剖宫产时协助胎头娩出的临床应用价值。方法：回顾分析2006年1月-2012年12月244例再次剖宫产胎头娩出困难患者，其中产钳协助胎头娩出（观察组）122例，未采用产钳助娩（对照组）122例。分析2组子宫切开至胎儿娩出时间（U-DI），产后出血量，新生儿窒息、新生儿头皮外伤、子宫切口撕裂的发生率。结果：观察组U-DI和产后出血量低于对照组（均P＜0.05），新生儿轻度窒息、新生儿重度窒息、新生儿头皮外伤、子宫切口撕裂发生率小于对照组（均P＜0.05）。结论：再次剖宫产徒手助胎头娩出困难时及时应用产钳协助胎头娩出，能有效缩短U-DI，降低新生儿窒息发生率，减少母婴损伤，是一种安全、有效、可行的方法。

Application of Obstetric Forceps in the Assisted Deliver of Fetal Head during the Repeat Cesarean Section

Objective：To evaluate the clinical value of the obstetric forceps in the assisted deliver of fetal head during repeat cesarean section, by our clinical practice. Methods：244 puerpera cases who have difficulties to deliver fetal head during the repeat cesarean section were retrospectively analyzed, in our hospital from January 2006 to December 2012. Those 122 cases who treated with the obstetric forceps to assist during delivering fetal head were appointed as the observation group, while other 122 cases who treated without the obstetric forceps were appointed as the control group. The U-DI,case of neonatal asphyxia,neonatal scalp trauma and uterine incision tear,and the volume of postpartum hemorrhage were analyzed. Results：U-DI in the observation group was significantly shorter than that in the control group （P〈0.05）. The case of neonatal asphyxia,neonatal scalp trauma and the mean volume of postpartum hemorrhage in the observation group were significantly less than those in the control group （P〈0.05）. The case of uterine incision tear in the observation group was less than that in the control group （P〈0.05）. Conclusions：The application of obstetric forceps in the assisted deliver of fetal head during the repeat cesarean section can effectively shorten the U-DI ,reduce the incidence of neonatal asphyxia, and reduce the damage to maternal and child. It is a safety,effective and practicable method.