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目的探讨在产程中改变孕妇体位来矫正胎方位异常的临床效果。方法选择在潜伏期经B超确诊为枕后位的初产妇96例,随机分为两组,每组48例。研究组在产程中指导孕妇取对侧侧俯卧位,利用胎儿重力,羊水的浮力,子宫收缩力的合力作用,使胎头在下降时逐渐从枕后位转至枕前位娩出,并与对照组比较。结果研究组有36例(84.71%)胎儿转为枕前位经阴娩出,剖宫产11例(15.29%)。对照组经阴道分娩为16例(22.94%),剖宫产32例(67.8%)。二组比较有显著的差异性(P<0.01)。研究组第一产程平均时间为308.2min,第二产程平均为59.9min。对照组第一产程平均时间为492.6min,第二产程平均为105.8min,二组比较有显著的差异性(P<0.01)。结论在产程中指导孕妇取对侧侧俯卧位来矫正枕后位是将难产转为顺产的有效方法。也是降低剖宫产率和难产率的有效方法。
Objective To investigate the clinical effect of changing the position of pregnant women during labor to correct abnormal fetal position. Methods 96 cases of primiparae who had been diagnosed as suboccipital posterior position by latent ultrasound were divided into two groups randomly, 48 cases in each group. The study group in the labor process to guide pregnant women to take contralateral prone position, the use of fetal gravity, amniotic fluid buoyancy, uterine contractility of the force, the fetal head gradually decreased from the occiput to the anterior occipital delivery, and with the control Group comparison. Results In the study group, 36 cases (84.71%) were converted to anterior transcervical delivery and 11 cases (15.29%) to cesarean section. The control group of vaginal delivery was 16 cases (22.94%), cesarean section in 32 cases (67.8%). There were significant differences between the two groups (P <0.01). The average duration of the first stage of labor was 308.2 minutes in the study group and 59.9 minutes in the second stage of labor. The mean time of the first stage of labor in the control group was 492.6 minutes, and the average of the second stage of labor was 105.8 minutes. There was significant difference between the two groups (P <0.01). Conclusions It is an effective way to guide dystocia to spontaneous labor by guiding the pregnant woman to take the contralateral prone position in the labor process. It is also an effective method to reduce cesarean section rate and dystocia rate.