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目的观察分娩活跃期经阴道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100例,经积极干预,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纠正胎方位。结果100例经手法旋转后,79例成功自娩,转位成功率为79%,其中21例转位失败者16例行胎头吸引术,3例产钳助产,2例剖宫产结束分娩,新生儿体重≤3 500 g者,手法转位成功率高,达86%;新生儿体重>3 500 g者,手法转位成功率为47%,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 abnormal vaginal position corrected vaginal freehand during the active part of labor. Methods 100 cases of active stage of labor were selected. After active intervention, the fetal position still could not rotate spontaneously to the anterior occipital position. The obstructive labor was followed by occiput posterior position and occipital transverse position. Results After 100 cases were rotated by hand, 79 cases were delivered successfully and the success rate of transposition was 79%. Among them, 21 cases failed in transposition, 16 cases had fetal head aspiration, 3 forceps assisted delivery and 2 cesarean end delivery , Neonates with body weight≤3 500 g had a high success rate of 86% in transplanting; neonates with weight> 3500 g had a successful success rate of 47% (P <0.01) . Conclusions Manual reduction can correct the continuous occipital transverse position, and the occiput posterior position is the anterior occipital region, which can improve the flexion of the fetal head and reduce the incidence of dystocia.