肩难产(shoulder dystocia)是一种不常见的分娩并发症。胎头娩出后,胎儿前肩被嵌顿于耻骨联合后上方,用常规助产方法不能娩出胎儿双肩,称为肩难产。由于其常在儿头娩出后意外发生,情况危急,贻误时机或处理不当,可造成母儿严重并发症。因此,早期预测、识别和正确处理肩难产是非常重要的问题。 1 肩难产的发生率及病因国外报道肩难产发生率为0.15％～0.6％,国内报道为0.15％。其发生与以下几种因素有关。 1.1 肩难产的发生与胎儿体重密切相关。Benedetti等报道肩难产发生率占所有顶先露阴道分娩的0.37％,如胎儿体重>4000g发生率可高达1.7％,胎 Shoulder dystocia is an uncommon childbirth complications. After the fetal head was delivered, the fetal anterior shoulder was incarcerated at the top of the pubic symphysis, using conventional midwifery methods to deliver the fetal shoulders, known as shoulder dystocia. Because of its accidental after childbirth, the situation is critical, delaying the timing or improper handling, can cause serious complications of mother and child. Therefore, early prediction, identification and proper treatment of shoulder dystocia is a very important issue. The incidence and etiology of a shoulder dystocia Shoulder dystocia incidence of foreign reports of 0.15% to 0.6%, the domestic coverage of 0.15%. Its occurrence with the following factors. 1.1 The incidence of shoulder dystocia and fetal weight are closely related. Benedetti reports that the incidence of shoulder dystocia accounted for 0.37% of all top vaginal delivery, such as fetal weight> 4000g incidence rate of up to 1.7%, fetal