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[长骨盆在临床实践和医学教育中的重要性(作者译)]

[The importance of the long pelvis in clinical practice and medical education (author's transl)].

作者信息

Martius G, Loock W

出版信息

Geburtshilfe Frauenheilkd. 1981 Feb;41(2):87-90. doi: 10.1055/s-2008-1036968.

Abstract

The importance of the long pelvis with lumbo-sacral assimilation in obstetrics is evaluated. 111 x-rays of the pelvis in cases with abnormal deliveries were evaluated and compared to the clinical data. The incidence of the long pelvis was not increased in the total group, nor in the 100 cases with abnormal deliveries. A long pelvis was present in 30.2% of the 43 breech presentations. In 4 cases with a funnel pelvis vaginal delivery occurred without difficulty. In 42 posterior vertex presentation the long pelvis appears to have a pathogenetic importance regarding the primary posterior position. The further course of the delivery was not influenced by the long pelvis. In 7 cases of low transverse arrest, 4 had a long pelvis but only 1 had a funnel pelvis to explain this abnormal position. In summary, the long pelvis even in its most severe form, the funnel pelvis, does not block the adaptation processes in the lesser pelvis. The changes in the pelvic inlet due to the lumbo-sacral assimilation have an etiologic importance on the initial presentation at the inlet such as breech presentation, military vertex presentation, brow presentation, or Roederers anomaly. However, no prognostic value for the mechanism of the delivery can be derived from the initial presentation. The delivery dose not depend on the long pelvis but on the malpresentation when delivery becomes necessary.

摘要

评估了伴有腰骶椎融合的长骨盆在产科中的重要性。对111例分娩异常病例的骨盆X线片进行了评估,并与临床数据进行了比较。在整个组中以及在100例分娩异常的病例中,长骨盆的发生率均未增加。在43例臀位分娩中,30.2%存在长骨盆。在4例漏斗骨盆病例中,阴道分娩顺利。在42例枕后位分娩中,长骨盆似乎对原发性枕后位具有致病重要性。分娩的进一步过程不受长骨盆的影响。在7例低位横位阻滞病例中,4例有长骨盆,但只有1例有漏斗骨盆来解释这种异常胎位。总之,长骨盆即使是最严重的形式,即漏斗骨盆,也不会阻碍小骨盆的适应过程。腰骶椎融合导致的骨盆入口变化对入口处的初始胎位,如臀位、军人型头位、额位或勒德雷尔畸形,具有病因学重要性。然而,初始胎位对分娩机制没有预后价值。分娩不取决于长骨盆,而是在需要分娩时取决于胎位异常。

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