臀位剖宫产——新生儿骨折的预防
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摘要
臀位为产科常见的异常胎位,单胎足月臀位发生率为3%～5%。臀位围产儿发病率和死亡率高于头位,且臀位阴道分娩围产儿发病率和死亡率亦显著高于剖宫产者。尽管普遍报道臀位剖宫产安全,但仍有一定比例的新生儿产伤,尤其是臀位新生儿骨折。文章重点阐述臀位剖宫产新生儿产伤焦点问题及可对应采取的预防措施及处理,以达到尽可能降低新生儿损伤的目的。
The breech presentation is a common occurrence in the obstetrical practice,accounting for about 3-5% of singleton fetuses at delivery.The Term Breech Trial demonstrated the planned cesarean section to be associated with a significant reduction in perinatal mortality and short term morbidity.Although the safety of cesarean section is widely reported,there is still a certain proportion of neonatal injuries,especially fracture.This paper focuses on the neonatal birth injury by cesarean section of breech presentation and the corresponding preventive measures and treatment,in order to reduce the newborn injury as much as possible.
The breech presentation is a common occurrence in the obstetrical practice,accounting for about 3-5% of singleton fetuses at delivery.The Term Breech Trial demonstrated the planned cesarean section to be associated with a significant reduction in perinatal mortality and short term morbidity.Although the safety of cesarean section is widely reported,there is still a certain proportion of neonatal injuries,especially fracture.This paper focuses on the neonatal birth injury by cesarean section of breech presentation and the corresponding preventive measures and treatment,in order to reduce the newborn injury as much as possible.
引文
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[8]Rahul P,Grover AR,Ajoy SM.Bilateral humerus and right femur fracture in a newborn after cesarean section for breech presentation in a twin pregnancy:a very rare case report[J].J Orthop Case Rep,2017,7(1):9-11.
[9]Rayl J,Gibson PJ,Hickok DE.A population-based case-control study of risk factors for breech presentation[J].Am J Obstet Gynecol,1996,56:28.
[10]Yuji K,Yoshinobu H,Tsuyoshi H,et al.Delayed birth-related femur fracture after cesarean section:a case report[J].Am JPerinatol Rep,2018,8:e158-e160.(2018-10-20收稿)
[2]Sim?es R,Valadares NJD,Bernardo WM,et al.Elective cesarean section for term breech delivery[J].Revista Da Associa??o Médica Brasileira,2015,61(5):391.
[3]Ibrahima F,Nonga BN,Eone DH,et al.Fracture of the femur of a newborn after cesarean section for breech presentation and fibroid uterus:a case report and literature review:[J].J Orthop Case Rep,2014,4(1):18-20.
[4]Hannah ME,Hannah WJ,Hewson SA,et al.Planned caesarean section versus planned vaginal birth for breech presentation at term:a randomised multicentre trial[J].Lancet,2000,356:1375-1383.
[5]Toker A,Perry ZH,Cohen E,et al.Cesarean section and the risk of fractured femur[J].Isr Med Assoc J,2009,11(7):416-418.
[6]Nadas R.Obstetric fracture[J].Eur J Pediatr Surg,1992,2:165-168.
[7]Alexander L,Hauth D,Landon J,et al.For the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network:fetal injury associated with cesarean delivery[J].Obstet Gynecol,2006,108:885-890.
[8]Rahul P,Grover AR,Ajoy SM.Bilateral humerus and right femur fracture in a newborn after cesarean section for breech presentation in a twin pregnancy:a very rare case report[J].J Orthop Case Rep,2017,7(1):9-11.
[9]Rayl J,Gibson PJ,Hickok DE.A population-based case-control study of risk factors for breech presentation[J].Am J Obstet Gynecol,1996,56:28.
[10]Yuji K,Yoshinobu H,Tsuyoshi H,et al.Delayed birth-related femur fracture after cesarean section:a case report[J].Am JPerinatol Rep,2018,8:e158-e160.(2018-10-20收稿)