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目的探讨下腹部横切口子宫下段剖宫产术胎头娩出困难的原因及处理方法。方法对河南省宁陵县妇幼保健院自2004年7月至2009年6月子宫下段剖宫产术中胎头娩出困难者105例产妇的临床资料进行回顾性分析。结果 105例产妇中胎头娩出困难的原因为胎头高浮35例,占33.33%;胎头深定骨盆29例,占27.62%;麻醉效果欠佳16例,占15.24%;巨大儿8例,占7.62%;胎儿过度仰伸7例,占6.67%;腹壁切口或子宫切口相对较小6例(包括子宫狭窄环2例),占5.71%;其他4例,占3.81%。结论正确把握剖宫产时机,术前充分估计胎头娩出的难易程度、适当的手术切口、良好的麻醉及娴熟的手术技巧有利于母婴安全,降低母婴并发症发生率。
Objective To investigate the causes and treatment of difficult delivery of the fetal head of the lower uterine segment of the lower abdominal transverse incision. Methods Retrospective analysis was performed on the clinical data of 105 maternal women who had difficulties in delivering fetal head during cesarean section in Ningling MCH from July 2004 to June 2009 in Henan Province. Results 105 cases of mothers in the fetal head was difficult due to 35 cases of fetal head floating, accounting for 33.33%; deep fetal pelvis in 29 cases, accounting for 27.62%; poor anesthesia in 16 cases, accounting for 15.24%; macrosomia in 8 cases , Accounting for 7.62%; fetus over-stretched in 7 cases, accounting for 6.67%; abdominal incision or uterine incision relatively small in 6 cases (including 2 cases of uterine stenosis ring), accounting for 5.71%; the other 4 cases, accounting for 3.81%. Conclusions Correctly grasp the timing of cesarean section, fully estimate the ease of fetal head delivery before surgery, appropriate surgical incision, good anesthesia and skilled surgical techniques are beneficial to maternal and child safety and reduce the incidence of maternal and child complications.