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患者孕足月,孕2产0。1992年8月5日临产,正常规律宫缩,宫口开大至4cm 后,产程无进展持续1周来院就诊。查体:宫底剑突下3横指,头先露高浮。胎心音140次/分,宫口开大4cm,羊膜未破,前羊水较多,宫缩时前羊水囊较大,宫缩间歇时前羊水囊几乎消失,可触清头位正常,宫颈无水肿。行人工破膜后放出患者孕足月,孕2产0。1992年8月5日临产,正常规律宫缩,宫口开大至4cm 后,产程无进展持续1周来院就诊。查体:宫底剑突下3横指,头先露高浮。胎心音140次/分,宫口开大4cm,羊膜未破,前羊水较多,宫缩时前羊水囊较大,宫缩间歇时前羊水囊几乎消失,可触清头位正常,宫颈无水肿。行人工破膜后放出淡黄色羊水约500ml,同时给缩宫素0.2U 合谷穴封闭,25%葡萄糖注射液60ml 加维生索 C1g 静脉推注。约5分钟后,宫缩增强、规律,宫口相应开大,1小时后宫口开全,先露随之下降,顺利娩出一男性活婴,产后顺利。在临产早期,前羊水囊起到扩张宫颈的作用,但在宫口开大4～6cm 时,若胎泡仍不能形成,并随官缩增强、羊水囊增大,宫缩间歇羊水囊缩小,即交通性羊水囊。此交通性羊水阻碍了胎头下降,造成产程停滞。临床上遇有无明显头盆不称、宫缩规律、产程停滞者,应考虑到本症,及时内诊检查,人工破膜后,即可解除其阻力,使宫缩进展,产程加快。
Patients with full term pregnancy 2 pregnant 0. August 5, 1992 labor, normal contractions, cervix open up to 4cm, no progress of labor for 1 week to the hospital. Physical examination: Palace under the sword suddenly 3 horizontal refers to the first exposed high float. Fetal heart sound 140 beats / min, the cervix open 4cm, amniotic membrane is not broken, more amniotic fluid before the contraction of the former large amniotic fluid sac, uterine contractions intermittent when the amniotic fluid sac almost disappeared, touch the head clearance of normal, cervical No edema. After the line of artificial rupture of patients released full-term pregnancy, pregnancy 2 producing 0. 1992 August 5 labor, normal contractions, cervix open up to 4cm, no progress of labor for 1 week to the hospital. Physical examination: Palace under the sword suddenly 3 horizontal refers to the first exposed high float. Fetal heart sound 140 beats / min, the cervix open 4cm, amniotic membrane is not broken, more amniotic fluid before the contraction of the former large amniotic fluid sac, uterine contractions intermittent when the amniotic fluid sac almost disappeared, touch the head clearance of normal, cervical No edema. Row artificial rupture of light yellow amniotic fluid release about 500ml, at the same time to oxytocin 0.2U Hoku closed, 25% glucose injection 60ml plus vitamin C 1g intravenous injection. About 5 minutes later, contractions increased, regular, cervix corresponding open large, 1 hour after opening the cervix, first dew along with the smooth delivery of a male living baby, postpartum smoothly. In the early labor, the former amniotic fluid balloon to play the role of expansion of the cervix, but in the cervix to open large 4 ~ 6cm, if the foam is still not formed, and with the official contraction enhanced, increased amniotic sac, uterine contractions intermittent oligohydramnios shrink, That is, traffic amniotic fluid sac. This traffic amniotic fluid hinder the head down, resulting in labor stagnant. Clinically, there is no obvious cases of cephalopelvic contractions, contractions, labor stagnant, should take into account the disease, timely examination, artificial rupture of the membrane, you can lift the resistance, so that contractions progress, labor to speed up.