Goodwin T M, Banks E, Millar L K, Phelan J P
Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA.
Am J Obstet Gynecol. 1997 Aug;177(2):463-4. doi: 10.1016/s0002-9378(97)70218-7.
We present three cases of shoulder dystocia unrelieved by standard maneuvers, including cephalic replacement. Symphysiotomy was performed in an effort to preserve fetal life. All three infants sustained severe neurologic injury and later died. Maternal morbidity including urinary incontinence was significant but responded to treatment. Symphysiotomy may be the only method of relieving some cases of shoulder dystocia, but its role remains unclear because of operator inexperience and maternal morbidity.
我们报告了3例经包括胎头复位在内的标准手法仍无法缓解的肩难产病例。为挽救胎儿生命实施了耻骨联合切开术。所有3例婴儿均遭受严重神经损伤，随后死亡。包括尿失禁在内的产妇并发症严重，但经治疗后有改善。耻骨联合切开术可能是缓解某些肩难产病例的唯一方法，但其作用仍不明确，原因是术者经验不足以及产妇出现并发症。
