摘要
目的研究产程不同时相干预预防持续性枕后位的措施，以降低持续性枕后位的发生率，改善分娩结局。方法将９６例枕后位产妇随机平均分为两组，对研究组的产妇施行针对产程不同时相的一系列干预措施，包括人工破膜、纠正异常胎轴、产妇采取与胎背同侧的高坡侧俯卧位、徒手扩张宫颈及徒手旋转胎头。结果研究组活跃期及第二产程较对照组短，研究组活跃期先露下降平均速度及宫口扩张平均速度均快于对照组，研究组的持续性枕后位发生率及胎儿窘迫发生率均低于对照组，产后出血量少于对照组（Ｐ＜０．０５）。结论综合性干预措施安全、有效、易行。
To study corresponding prophylactic measures on parturients with occipito-posterior position according to the periods of labor, and to decrease the incidence of persistent occipito-posterior position Methods 96 parturients with occipitoposterior position who gave their birth during Dec. 1, 1993 and Mar. 31, 1994 in Shandong Provincial Hospital were randomly divided into two groups, 48 cases in the study group and 48 cases in the control group. No significant difference was found on body heights, weights and gestational ages of the gravidas, average birth weight of the neonates, fetal position at the beginning of labour, the mode of delivery, and the incidence of PROM between the two groups (P all>0. 05) . For the study group, parturients adopted lateral low prone position on the same side to which the fetal occiput and the fetal spine were directed, artificially ruptured membranes, rectified oblique fetal axis, manfetal dilatation of cervix and manual rotation of fetal presentation, while other managements were manitained the same or likely in the two groups.Results The length of active phase of the study group was 3hismin± lh19min,while the second stage was 23min ±11min and concerning the control group, 1h 39min ± 47min and 47min ± 20min repectively. In course of the active phase, the average speed of the descending of the fetal presentation and the dilatation speed of the cervix were 3. 46 ± l. 34cm/h and 6. 56 ± 2. 60cm/h seperately in the study group, and 0. 70±0. 43cm/h and l. 88±0. 52cm/h in the control group. Of the two groups. the incidences of persistent occipito-posterior position were 0 and 41. 7%, operative delivery rates were 4. 17 % and 39. 58%, incidences of fetal distress were 6. 25% and 31. 25 %, the volumes of postpartum bleeding were 102.39±38. 74ml and 283. 25 ± 76. 63ml. The value of P were all proved to be less than 0. 01 by statistical testing.Conclusions The above mentioned prophylactic intervening measures are highly effective in decreasing the incidence of persistent occipito-posterior position. For it's economical, safe, convenient and adoptable, it may be widely used by obstetricians.
出处
《现代妇产科进展》
CSCD
1996年第2期126-129,共4页
Progress in Obstetrics and Gynecology
关键词
持续性枕后位
干预
预防
Intervening
Dystocia
Persistent occlipito-posterior position
