复发性肩难产：发生率及危险因素分析。

Recurrent shoulder dystocia: analysis of incidence and risk factors.

机构信息

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

出版信息

Am J Perinatol. 2012 Aug;29(7):515-8. doi: 10.1055/s-0032-1310522. Epub 2012 Apr 11.

DOI:10.1055/s-0032-1310522

PMID:22495895

Abstract

OBJECTIVES

To determine the rate and associated risk factors for recurrent shoulder dystocia (SD).

STUDY DESIGN

A retrospective analysis was performed of patients delivered from January 1991 to June 2001. Patients with and without recurrent SD were identified and compared.

RESULTS

Among the 267,228 vaginal births during the study period, there were 1904 cases of SD (0.7%) and 270 patients with one additional vaginal birth. The recurrent SD rate was higher than the general population (3.7% versus 0.7%, odds ratio 7.36, 95% confidence interval 3.68 to 14.23, p < 0.001). Patients with recurrent SD had a slightly higher mean birth weight with the second delivery, but this difference was not statistically significant (4173 ± 544 g versus 4017 ± 577 g, p = 0.39).

CONCLUSION

Prior SD is a risk factor for recurrence in a subsequent delivery, but our results demonstrate that the rate appears to be lower than previously estimated. Most variables, including birth weight, do not appear to be useful parameters in predicting recurrence.

摘要

目的

确定复发性肩难产（SD）的发生率和相关危险因素。

研究设计

对 1991 年 1 月至 2001 年 6 月间分娩的患者进行回顾性分析。确定并比较有和无复发性 SD 的患者。

结果

在研究期间的 267228 例阴道分娩中，有 1904 例发生 SD（0.7%），270 例患者有一次额外的阴道分娩。复发性 SD 的发生率高于一般人群（3.7%比 0.7%，优势比 7.36，95%置信区间 3.68 至 14.23，p<0.001）。第二次分娩时，复发性 SD 患者的平均出生体重略高，但差异无统计学意义（4173±544g 比 4017±577g，p=0.39）。