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目的:观察分娩活跃期徒手纠正胎头位置异常的临床效果。方法:选择产程进入活跃期110例,经加强产力,改变母体体位等处理,胎方位仍不能自然旋转为枕前位,产程阻滞的持续枕后位、枕横位,施行经阴道徒手旋儿头,辅以经孕妇腹部推儿背为脊前方位联合手法。结果:110例经手法旋转后,84例成功自娩,转位成功率为76.36%,其中26例转位失败者14例行胎头吸引术,8例产钳助产,2例剖宫产结束分娩,转位失败率为23.64%。新生儿体重≤3500g者,手法转位成功率高,达87.50%;新生儿体重>3500g者,手法转位成功率为46.67%,两者差异有显著性(P<0.01)。结论:手法复位可矫正持续性枕横位、枕后位为枕前位,改善胎头俯屈,降低难产发生率。
OBJECTIVE: To observe the clinical effect of correcting the position of fetal head abnormally by active hand during childbirth. Methods: 110 cases of active stage of labor were selected. After the birth force and maternal body position were strengthened, the fetal position could not rotate spontaneously to the anterior occipital position. The obstructive labor was followed by occipital posterior position and occipital transverse position, Aberdeen, supplemented by the abdomen of pregnant women push the back of the back for the ridge combined approach. Results: After the rotation of the hand in 110 cases, 84 cases succeeded in delivery and the success rate of transposition was 76.36%. Among them, 26 cases failed in transposition and 14 cases received fetal traction, 8 forceps assisted delivery and 2 cases ended cesarean section Childbirth, translocation failure rate was 23.64%. Neonatal weight ≤ 3500g, the success rate of transposition by hand was high, reaching 87.50%; neonates weighing> 3500g, the success rate of manipulation transposition was 46.67%, the difference was significant (P <0.01). Conclusion: Manipulative reduction can correct the continuous occipital transverse position, posterior occiput posterior position, improve fetal head flexion, reduce the incidence of dystocia.