Iffy L, Varadi V, Jakobovits A
Department of Obstetrics and Gynecology and Pediatrics UMDNJ-New Jersey Medical School, Newark.
Zentralbl Gynakol. 1994;116(1):33-7.
The intrapartum background of fetal injuries associated with shoulder dystocia was studied retrospectively on the basis of 107 relevant medical records. Intrapartum use of oxytocin and protraction-arrest disorders, the latter particularly during the second stage of labor, were frequent findings. Delivery was effected by forceps or vacuum extraction in almost one-half of the cases. Shoulder dystocia related permanent fetal impairments were closely connected to macrosomia. The fetal weight was > or = 4,000 grams in about 75% and > or = 4,500 grams in approximately 40% of the instances. Permanent hypoxic or traumatic cerebral damage was documented in almost one-third of the cases. The data indicate that in connection with coincidental neonatal afflictions, the birth weights of the fetuses are higher and instrumental extractions are more frequent than in relation to all clinically diagnosed cases of shoulder dystocia.
基于107份相关病历，对与肩难产相关的产时胎儿损伤背景进行了回顾性研究。产时使用催产素以及产程延长-停滞紊乱，后者尤其在第二产程期间，是常见的发现。几乎一半的病例通过产钳或真空吸引助产。与肩难产相关的永久性胎儿损伤与巨大儿密切相关。约75%的病例胎儿体重≥4000克，约40%的病例胎儿体重≥4500克。近三分之一的病例记录有永久性缺氧或创伤性脑损伤。数据表明，与同时发生的新生儿疾病相关的胎儿出生体重更高，器械助产比所有临床诊断的肩难产病例更频繁。
