摘要
目的探讨临产后中转剖宫产手术的时机。方法对湖北省妇幼保健院2011年1月至2012年12月237例临产后中转剖宫产手术指征及时机进行回顾性分析。结果在237例，临产后中转剖宫产手术指征中，排序前3位的分别为持续性枕后位77例，占32．48％；胎儿窘迫45例，占18．98％；持续性枕横位39例，占16．45％。持续性枕后位及枕横位中转剖宫产的时机多在宫口开大4～5cm之间；胎儿窘迫及活跃期停滞多发生于活跃早期，宫口开大3～4m；胎头下降停滞及头盆不称多发生宫口开大5cm以后。结论临产后根据产程的进展，活跃早期注意胎儿窘迫的发生，活跃中期注意胎位的异常，活跃后期注意胎头的下降等情况，必要时中转剖宫产，减少母儿并发症。
Objective To study the time of transiting cesarean delivery after labor. Methods The indications and best time of transiting cesarean delivery after labor were retrospectively analyzed among 237 cases of transiting cesarean delivery after labor in Hubei Provincial Maternal and Child Health Hospital between January 2011 and December 2012. Results Among the indications for transiting cesarean delivery after labor, the first three were persistent occipitoposterior position （77, 32.48% ）, fetal distress （45, 18.98% ）, and persistent occipitotransverse position （ 39, 16.45% ）. The best time of transiting cesarean delivery after persistent occipitoposterior position or persistent occipitotransverse position was when the cervical opening reached 4-5cm. Fetal distress and protracted active phase often occurred at early active stage and when the cervical opening was about 3-4cm. Relative cephalopelvic disproportion and protracted descent often occurred when the cervical opening reached 5cm. Conclusion According to the stage of labor, we should pay attention to the occurrence of fetal distress at early active stage, the abnormal fetal position at the mid active stage, and protracted descent at late stage. If necessary, transiting cesarean delivery can be chosen to decrease maternal and neonatal complications.
出处
《中国妇幼健康研究》
2014年第1期97-98,共2页
Chinese Journal of Woman and Child Health Research
关键词
临产
剖宫产
手术指征
持续性枕后位
parturiency
cesarean delivery
operation indication
persistent occipitoposterior position
