臀位妊娠分娩方式的选择

①目的　分析臀位妊娠影响母儿结局的因素及初产妇是否可以选择阴道分娩。②方法　对我院单胎臀住妊娠369例孕产妇的资料进行整理分析,比较初产妇及经产妇的分娩方式。单因素及多因素分析影响单胎臀位妊娠的母儿结局的因素。③结果　初产妇组143／256(55.9％),经产妇组78／113(69％)选择阴道分娩,两组产妇分娩方式的选择上有显著性差异,但这两组产妇的围生儿结局相似,母亲结局相似(P>0.05)。多因素分析提示,足月妊娠及剖宫产对臀位妊娠的新生儿有利;婴儿结局与产次无关。但多产和剖宫产对母亲来说则是不利因素。④结论　初产妇选择阴道分娩的条件和经产妇相似。臀位妊娠分娩方式的选择应全面考虑围生儿及母亲因素,结合产妇及家属的意愿来决定。

The choice of mode of delivery for breech presentation in nulliparous women

Objective To analyze the factors affecting the maternal and neonatal outcomes for pregnant women of breech presentation and evaluate whether the nulliparous women of breech presentation can have vaginal delivery. Method The clinical data of total 369 cases of singleton breech presentation admitted in our hospital from January 1991 to December 2002 was collected and compared (including mode of delivery, maternal and perinatal outcomes ). The factors which have an effect on maternal and perinatal outcomes was also discussed through univariate and multivariate analysis. Results There were 143 of total 256 cases in nulliparous women group and 78 of 113 cases in multiparous group who had a trial of vaginal delivery. There were significant differences of choice of mode of delivery between the two groups, however, they have similar maternal and perinatal outcomes (P > 0. 05 ) . Multivariate analysis indicates that term pregnancy and cesarean section are favorable factors for the newboms, Multiparity are not parity - related with perinatal outcomes. But multiparity and CS have an adverse effect on the maternal outcomes. Conclusion When determine the mode of delivery for breech presentation, we must take all into account the maternal factors, the perinatal factors as well as the will of the patients and their relatives, but parity is not a major concern.