剖宫产术中胎儿娩出困难的临床分析

目的探讨剖宫产术中取胎困难的原因及处理对策.方法对680例剖宫产进行回顾性分析.以术中发生取胎困难的135例为观察组,以同期取胎顺利的545例剖宫产为对照组.结果胎儿娩出困难主要原因:胎儿因素占70.37%、子宫因素占14.81%、医源性因素占8.15%、术中子宫切口位置选择不当占4.42%、腹壁切口或子宫切口相对小占2.22%.观察组发生产后出血、子宫切口撕裂、脏器损伤、新生儿窒息、新生儿产伤等并发症均明显高于对照组(P《0.01).结论剖宫产术只有手术指征选择准确、手术操作娴熟、技巧良好、耐心、细致应对术中可能出现的问题,才能确保母婴安全.

Clinical analysis of difficulty in delivery of the fetus in cesarean section

Objective To investigate the cause,prevention and management of the difficulty in delivery of the fetus in cesarean section.Methods 680 cases of cesarean section were analyzed retrospectively for etiology and management.135 cases who were found difficulty during cesarean section were in observation group.Whereas 545 normal cases were in control group.Results The main causes of difficulry in delivery of the fetus induded fetal factor(70.37%),uterine factor(14.81%),iatrogenic factor((8.15%)), unsutiable incision location(4.42%),little incision((2.22%)).The rate of complications,such as postpartum hemorrhage,uterus incision tearing,organ injury,neonatal asphyxia and birth trauma,were higher in the observation group than those in the control group(P<0.01).Conclusion In order to ensure the safety of mather and the fetus,the cesarean indications should be chosen exactly and the operation should be performed expertly,skillfully and patiently.