剖宫产手术中胎头紧压后推头和倒转取臀的比较

作     者：Levy R. Chernomoretz T. Appelman Z. 朱亮 

作者机构：Department of Obstetrics and Gynecology Kaplan Medical Center Rehovot Hebrew University School of Medicine Jerusalem Rehovot 76100 Israel 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2005年第1卷第12期

页      码：19-20页

摘      要：Objective: To compare maternal and neonatal morbidity associated with two methods to extract the impacted fetal head during Cesarean delivery. Study design: We retrospectively analyzed cases with difficult extraction of the impacted fetal head during Cesarean section. We compared maternal and neonatal outcomes between cases that were delivered by head extraction following pushing through the vagina (“ push” method) and those that were delivered by the reverse breech technique (“ pull” method). Results: We reviewed 3105 Cesarean section reports. Difficult extraction necessitating the “ push” or “ pull” methods was noted in 48 (1.5% ) instances. Women that were delivered by the “ pull” method had significantly lower rate of postpartum fever (5% versus 46% ; odds ratios, 0.06; 95% confidence intervals, 0.007- 0.51) and extensions of the uterine incision (15% versus 50% ; odds ratio, 0.17; 95% CI, 0.04- 0.74) compared to those that were delivered by the “ push” method. Neonatal outcomes were good in all cases. Conclusions: In cases with difficult extraction of the impacted fetal head during Cesarean section, “ pull” method may result in lower maternal morbidity compared to the traditional “ push” method.

主 题 词：剖宫产手术 子宫切口 母儿结局 新生儿结局 产后发热 研究设计 

学科分类：1002[医学-临床医学类] 100211[100211] 10[医学] 

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