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本文对产程进入活跃期后枕后位52例经加强产力、改变母体体位、封闭水肿宫颈等处理,胎方位仍不能自然旋转为枕前位,产程阻滞的持续性枕后位(POPP)施行经阴道徒手旋转儿头,辅以经孕妇腹部推儿背为脊前方位联合手法。结果表明本法可矫正POPP为枕前位(OA),改善胎头俯屈降低难产发生,成功率达76.9%。本文提示,头位分娩评分与徒手旋转成功有相关性,轻微头盆不称即头盆评分6～7分者,与头盆关系正常≥8分者两组间无明显差异(x~2=0.26 P>0.05);而四项评分高低对徒手旋转成败有显著影响(x~2=28.23 P<0.01)。关键在于由枕后位(OP)1分增加到OA3分,使四项评分均达11分以上,绝大多数(80%)可经阴道分娩。
In this article, after the active stage of labor, 52 cases of posterior occiput posterior occipital position can not spontaneously rotate to the anterior occiput position and persistent posterior position (POPP) of obstructive labor due to strengthening productivity, changing maternal position and closing edematous cervix, The implementation of vaginal rotation of the child by hand, supplemented by the abdomen to push the back of the abdomen of pregnant women for the spinal cord combined approach. The results show that this method can correct POPP for anterior occipital position (OA), improve fetal head flexion and reduce the incidence of dystocia, the success rate of 76.9%. This article suggests that the first childbirth score is related to the success of the freehand rotation. There is no significant difference between the two groups (~2 = 0.26 P> 0.05). However, the scores of four scores had no significant effect on the hand rotation (x ~ 2 = 28.23 P <0.01). The key lies in the occiput posterior position (OP) 1 point increased to OA3 points, so that the four scores were 11 points or more, the vast majority (80%) can be vaginal delivery.