Rempen A
Universitäts-Frauenklinik Würzburg.
Z Geburtshilfe Perinatol. 1993 Mar-Apr;197(2):77-83.
The pressure exerted on the fetal head during the second stage of labor was continuously measured in 42 spontaneous deliveries with a new instrument. The pressure values were correlated to various obstetric variables. Typically, the head pressure remained elevated beyond the end of the uterine contraction in primiparae, whereas it decreased simultaneously with the amniotic pressure in multiparae. On the average, the head pressure was higher in primiparae indicating, together with the longer lasting bearing down period, a higher resistance of the birth canal. Deliveries with pudendal block or peridural analgesia showed no differences, but these two groups differed in other factors which might have influenced the results. Infusion of oxytocin during the course of labor was associated with higher head pressure values that could not be deduced from the hormone administration per se, but from a higher resistance of the birth canal. Maternal age did not influence the head pressure. Within physiological limits, the head pressure was independent from the size of the child and the maternal pelvis.
在42例自然分娩过程中，使用一种新型仪器持续测量了第二产程中胎儿头部所受的压力。压力值与各种产科变量相关。通常，初产妇的头部压力在子宫收缩结束后仍持续升高，而经产妇的头部压力则与羊膜压力同时下降。平均而言，初产妇的头部压力更高，这与更长的屏气用力时间一起表明产道阻力更大。接受阴部阻滞或硬膜外镇痛的分娩没有差异，但这两组在其他可能影响结果的因素上有所不同。分娩过程中静脉滴注缩宫素与更高的头部压力值相关，这并非源于缩宫素本身的给药，而是由于产道阻力增加。产妇年龄不影响头部压力。在生理范围内，头部压力与胎儿大小和产妇骨盆大小无关。
