初产妇分娩异常与肩难产的关系探讨

目的:探讨初产妇分娩异常与肩难产的关系。方法:选择2000～2008年以单胎、头位、初次分娩时发生肩难产的29例初产妇为研究组,随机选择同期条件与研究组相匹配的108例初产妇作为对照组,比较两组巨大儿的发生率、顺产及阴道助产比率、活跃期宫颈扩张速率及第一、第二产程的持续时间。结果:与对照组相比,研究组巨大儿发生率、子宫收缩乏力明显增加(P<0.05),第一产程减速期及第二产程时限明显延长(P<0.05),阴道手术助产的比率增加(P<0.01)。结论:初产妇分娩巨大胎儿、第二产程延长超过2 h及阴道手术助产均与肩难产有关。

Discussion of the relationship between abnormal delivery and shoulder dystocia among primiparous women

Objective:To explore the relationship between abnormal delivery and shoulder dystocia among primiparous women.Methods:Twenty-nine primiparous women with shoulder dystocia of single pregnancy and head position from 2000 to 2008 were selected as study group,108 primiparous women matched to the primiparous women in study group under the same circumstance were selected randomly as control group;the incidences of macrosomia,the proportions of spontaneous labor and vaginal assistant labor,the speeds of cervical dilation during active phase,the duration times of the first stage and the second stage of labor in the two groups were compared.Results:Compared with control group,the incidence of macrosomia and the proportion of uterine inertia in study group increased significantly(P<0.05),the duration time of deceleration period of the first stage of labor and the duration time of the second stage of labor prolonged significantly(P<0.05),the proportion of vaginal assistant labor increased significantly(P<0.01)Conclusion:Macrosomia,the duration time of the second stage of labor more than two hours,and vaginal assistant labor are related to shoulder dystocia among primiparous women.