Volume 19 Issue 6
Jun.  2021
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(6): 969-971
LU Ying, YOU Ai-jun, WU Jia-han. Risk factors of shoulder dystocia during maternal delivery and the evaluation of the intervention effect of posterior shoulder rotation[J]. Chinese Journal of General Practice, 2021, 19(6): 969-971. doi: 10.16766/j.cnki.issn.1674-4152.001962
Citation: LU Ying, YOU Ai-jun, WU Jia-han. Risk factors of shoulder dystocia during maternal delivery and the evaluation of the intervention effect of posterior shoulder rotation[J]. Chinese Journal of General Practice, 2021, 19(6): 969-971. doi: 10.16766/j.cnki.issn.1674-4152.001962
shu

Risk factors of shoulder dystocia during maternal delivery and the evaluation of the intervention effect of posterior shoulder rotation

doi: 10.16766/j.cnki.issn.1674-4152.001962
  • 1.

    Delivery Room, Ningbo Women's and Children's Hospital, Ningbo, Zhejiang 315000, China

Funds:

 2019ZH008

  • Received Date: 2020-05-29
    Available Online: 2022-02-16
    Abstract
  •   Objective  To explore the risk factors of shoulder dystocia during maternal delivery and the intervention effect of posterior shoulder rotation.   Methods  Data of 5 812 women who underwent vaginal delivery in Ningbo Women's and Children's Hospital from January 2019 to January 2020 were collected, including 59 women with shoulder dystocia (case group) and 5 753 women without shoulder dystocia (control group). Univariate and multivariate logistic regression analyses were conducted on the risk factors of shoulder dystocia. Among the 59 women with shoulder dystocia, 27 cases received conventional forearm pressure (case group 1), and 32 cases received posterior shoulder rotation (case group 2). The pregnancy outcomes of the groups were compared.   Results  Statistically significant differences in age, body mass index (BMI), gestational diabetes mellitus (GDM), uterine inertia and macrosomia were found between the case and control groups (all P < 0.05). Multivariate logistic analysis showed that BMI>27, GDM, uterine inertia and macrosomia were independent risk factors for shoulder dystocia (all P < 0.05). The total incidence rates of maternal and neonatal adverse outcomes in the case group were 20.34% and 13.56%, respectively, which were higher than those in the control group (6.67% and 0.42%, respectively; all P < 0.05). The total incidence rate of maternal and neonatal adverse outcomes in the case group 1 was 25.93%, which was not significantly different from at in case group 2 (15.62%, P>0.05). The total incidence rate of adverse neonatal outcomes in case group 1 was 25.93%, which was significantly higher than that in case group 2 (3.13%; P < 0.05).   Conclusion  Shoulder dystocia in maternal delivery have numerous risk factors, and thus targeted management is necessary to the prevention of shoulder dystocia. The incidence rates of adverse maternal and infant outcomes when the posterior shoulder rotation method is used are lower than those when the conventional shoulder pressing method is used for treating shoulder dystocia.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    谢幸, 孔北华, 段涛. 妇产科学[M]. 9版. 北京: 人民卫生出版社, 2018: 202.
    [2]
    MENTICOGLOU S. Shoulder dystocia: Incidence, mechanisms, and management strategies[J]. Int J Womens Health, 2018, 10(9): 723-732. http://www.onacademic.com/detail/journal_1000041685285599_26c1.html
    [3]
    袁平, 李仁兰, 刘梅. 改良式娩肩法对肩难产母儿预后的影响[J]. 护士进修杂志, 2018, 33(10): 913-914. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX201810016.htm
    [4]
    栗娜, 李秋玲, 常靓, 等. 非巨大儿肩难产发生的高危因素及其临床预测[J]. 中华妇产科杂志, 2015, 50(1): 17-21. doi: 10.3760/cma.j.issn.0529-567x.2015.01.005
    [5]
    路云霞, 杜荷荣. 肩难产的临床预防和处理分析[J]. 现代中西医结合杂志, 2015, 24(14): 1518-1520. doi: 10.3969/j.issn.1008-8849.2015.14.013
    [6]
    MURPHY C, RASHID W, HENDERSON C E. Gestational diabetes mellitus and frequency of blood glucose monitoring: A randomized controlled trial[J]. Obstet Gynecol, 2017, 130(1): 163-170. doi: 10.1097/AOG.0000000000002101
    [7]
    李洁, 嵇秀明. 苏州市某医院2015~2018年肩难产发生率横断面调查及危险因素分析[J]. 齐鲁护理杂志, 2020, 26(10): 44-47. doi: 10.3969/j.issn.1006-7256.2020.10.014
    [8]
    梅巧娣. 肩难产高危因素的Logistic回归分析及对母婴结局的影响[J]. 中国妇幼保健, 2019, 34(3): 505-507. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201903008.htm
    [9]
    李洁, 嵇秀明, 夏珊敏. 肩难产风险预警评分模型的构建研究[J]. 全科护理, 2020, 18(9): 1032-1036. https://www.cnki.com.cn/Article/CJFDTOTAL-JTHS202009003.htm
    [10]
    AL-HAWASH S, WHITEHEAD C L, FARINE D. Risk of recurrent shoulder dystocia: are we any closer to prediction?[J]. J Matern Fetal Neonatal Med, 2019, 32(17): 2928-2934. doi: 10.1080/14767058.2018.1450382
    [11]
    邓芬, 朱贝贝, 黄锟, 等. 不同妊娠期糖尿病诊断标准对不良妊娠结局的预测能力比较[J]. 现代预防医学, 2020, 47(5): 835-838, 902. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202005017.htm
    [12]
    张芝银, 李秀央, 郑国英, 等. 不良妊娠结局的影响因素分析[J]. 预防医学, 2020, 32(1): 94-97. doi: 10.3969/j.issn.1006-3110.2020.01.026
    [13]
    PAHLITZSCH T M J, HANNE L, HENRICH W, et al. Influence of foetal macrosomia on the neonatal and maternal birth outcome[J]. Geburtshilfe Frauenheilkd, 2019, 79(11): 1191-1198. doi: 10.1055/a-0880-6182
    [14]
    王晓怡, 何玉甜, 钟梅, 等. 肩难产发生的危险因素和临床特征的多中心分析[J]. 中华妇产科杂志, 2015, 50(1): 12-16. doi: 10.3760/cma.j.issn.0529-567x.2015.01.004
    [15]
    ROBSON M. Shoulder dystocia: Is it time to think differently?[J]. Aust N Z J Obstet Gynaecol, 2019, 59(5): 605-607. doi: 10.1111/ajo.13060
    [16]
    刘雁, 孙金燕, 万丽. 改良娩肩法应用于肩难产产妇中的效果分析[J]. 蚌埠医学院学报, 2020, 45(1): 128-130. https://www.cnki.com.cn/Article/CJFDTOTAL-BANG202001037.htm
    [17]
    黄静云. 屈大腿联合旋后肩法应用于肩难产的临床效果[J]. 中国妇幼保健, 2018, 33(16): 3815-3818. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201816068.htm
    [18]
    尤爱军. 旋后肩法在肩难产处理中的应用[J]. 中华护理杂志, 2015, 50(11): 1318-1321. doi: 10.3761/j.issn.0254-1769.2015.11.007
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (248) PDF downloads(3) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return