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目的探讨肩难产的早期预测、发生原因和正确及时处理办法,有效地降低母儿并发症的发生率。方法对21例肩难产病例的临床资料进行回顾性分析。结果21例中McRobert加压前肩法13例,McRobeh加旋肩法6例,McRoben加牵后臂法2例。三种助产方法发生新生儿臂丛神经损伤7例,其中4例发生不同程度的胸锁乳突肌损伤,2例经治疗1年后功能基本恢复,1例1年后恢复不理想。产妇发生会阴裂伤II度8例,发生产后大出血7例。结论必须系统正确的进行产前检查,评估胎儿体重,早期预测识别肩难产高危因素,分娩过程中正确的助产方法,减少对母儿的损伤,提高产科质量。
Objective To investigate the early prediction of shoulder dystocia, its causes and the correct and timely treatment to effectively reduce the incidence of maternal and child complications. Methods The clinical data of 21 cases of shoulder dystocia were analyzed retrospectively. Results In 21 cases, McRobert pressure anterior shoulder method in 13 cases, McRobeh plus rotary shoulder method in 6 cases, McRoben plus rear arm method in 2 cases. Three kinds of midwifery method occurred in 7 cases of neonatal brachial plexus injury, of which 4 cases of varying degrees of sternocleidomastoid injury, 2 cases of basic function recovered after 1 year treatment, 1 case 1 year after the recovery is not satisfactory. Maternal episiotomy occurred in 8 cases of perineal laceration, postpartum hemorrhage occurred in 7 cases. Conclusion Correct prenatal examination, fetal weight assessment, early prediction of high risk of shoulder dystocia, correct midwifery during childbirth, reduction of damage to maternal and child and improvement of obstetric quality must be systematically performed.