Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI.
Am J Obstet Gynecol MFM. 2021 Nov;3(6S):100438. doi: 10.1016/j.ajogmf.2021.100438. Epub 2021 Jul 22.
Fetuses with malpresentation and malposition during labor represent important clinical challenges. Women with fetuses presenting with malpresentation or malposition are at risk of increased perinatal complications, such as cesarean delivery, failure of operative vaginal delivery, neonatal acidemia, and neonatal intensive care admission. Intrapartum ultrasound has been found to be more reliable than digital examination in assessing malpresentation and malposition. The use of intrapartum ultrasound to assess fetal position and presentation, in addition to fetal attitude, to predict and aid in decision making regarding delivery can help in improving management decision making. Cephalic malpresentation and malposition is a unique subset of fetal orientation and can benefit from intrapartum ultrasound identification and assessment for delivery.
分娩时胎儿位置不正和胎位异常是重要的临床挑战。胎儿位置不正或胎位异常的孕妇发生围产期并发症的风险增加，如剖宫产、阴道分娩失败、新生儿酸中毒和新生儿重症监护病房收治等。与阴道检查相比，分娩时超声检查评估胎儿位置和胎位更可靠。分娩时超声检查除了评估胎儿姿势外，还可用于评估胎方位，预测和辅助决策分娩，有助于改善管理决策。头位异常是胎儿方位的一个独特亚组，可以通过分娩时超声识别和评估获益。
