ABSTRACT
Resumen ANTECEDENTES: Las anomalías de posición fetal se asocian con la deficiente evolución de trabajo de parto. El ultrasonido durante el trabajo de parto es una herramienta complementaria para confirmar los hallazgos obtenidos en la exploración vaginal y definir el tipo de anomalía de posición fetal. CASOS CLÍNICOS: Caso 1: Paciente de 24 años, primigesta, con 41 semanas de embarazo y ruptura prematura de membranas. Ingresó al área de tococirugía por completar la dilatación y borramiento cervical, sin evolución del trabajo de parto durante 120 minutos. El ultrasonido transabdominal suprapúbico reportó el signo de estrabismo. El embarazo finalizó por cesárea y se corroboró la anomalía fetal de posición occipito-posterior. Caso 2: Paciente de 29 años, primigesta, con 39 semanas de embarazo e hipertensión gestacional, quien completó la dilatación y borramiento cervical y durante 120 minutos no hubo descenso del polo cefálico. A la exploración vaginal se detectó variedad de posición fetal occipito-transversa. El ultrasonido transabdominal suprapúbico mostró el signo de estrabismo. El embarazo finalizó mediante cesárea y la evolución para la madre y su hijo fue satisfactoria. CONCLUSIONES: La ecografía es un estudio efectivo para la detección de anomalías de posición, pues disminuye las complicaciones materno-fetales asociadas con trabajo de parto extendido. Sin embargo, reportar la experiencia de solo dos casos no podría tener validez para sustentar dicha afirmación.
Abstract BACKGROUND: The anomalies of the position are the cause of failure in the task of labor. The ultrasound during labor is a complementary tool to confirm the clinical findings in the vaginal examination and define the type of position abnormality. OBJECTIVE: to report on the use of ultrasound during abnormal labor, such as the detection of the position abnormality. CLINICAL CASES: Case 1: 24-year-old patient with 41 weeks of gestation (SDG) and premature rupture of membranes, entered the area of tochosurgery to complete the dilation and cervical neck, nevertheless worked and delivery for 120 minutes . A suprapubic transabdominal ultrasound was performed, finding a sign of strabismus, the resolution was by caesarean section and an occipito-posterior position anomaly was corroborated. Case 2: 29-year-old patient with 39 SDG and gestational hypertension, it is deduced from the labor, the cervical neck was dilated and for 120 minutes, there was no decrease of the cephalic pole, a variety of occipito place -transverse, suprapubic transabdominal ultrasound was performed, finding a sign of strabismus. The pregnancy ended by caesarean section and the evolution for the mother and her child was satisfactory. CONCLUSIONS: Ultrasound is an effective study for the detection of position abnormalities, since it reduces maternal-fetal complications associated with extended labor. However, reporting the experience of only two cases could not be valid to support this assertion.
ABSTRACT
Objective To analyze the clinical effect of a bifurcated ball frame designed for undergraduate research to assist hand-knee position,avoid physical exertion and increase comfort.Methods Randomized controlled trials consisted of 260 occipital (posterior) primiparous women born during labor,and were randomly divided into the observation group and the control group with 130 cases each.The observing group's mothers were on the yoga ball on the device.The angle and height of the frame and the ball plate were adjusted according to the maternal body type,so that the yoga ball at the chest and the cross could effectively support the maternal weight loss knee burden,and both sides of the small abdominal yoga ball could be effectively posted.After the adjustment was completed,the maternal relaxes and gently shakes the body in one direction so that the small yoga ball on the ventral side forms a continuous soothing push.The control group leaned forward on both knees (with protective gear) and supported themselves with both hands or both fists,swaying the pelvis or crawling forward.Comparing the two groups of vaginal delivery rate,maternal postural maintenance time,maternal dehvery experience,and effective correction rate of occipital position.Results The time of postoperative maintenance in the observation group was (49.51 ±10.62) minutes,and that of the control group was (18.31 ± 9.72) minutes.The difference between the two groups was statistically significant (t=6.69,P ＜0.05).The effective correction of abnormal fetal position rate,spontaneous delivery rate and comfort rate were 82.30％ (107/130),77.69％ (101/130),and 99.23％ (129/130),respectively in the observation group,and 27.69％ (36/130),33.85％ (44/130),3.84％ (5/130),respectively in the control group,the differences between the two groups were statistically significant (x2 =4.06,4.15,5.61,all P ＜0.05).Conclusions The undergraduate design of this sort of ball delivery group has a significant effect on the extraversion of the assisted position to the fetal position.
ABSTRACT
Objective To discuss the clinical application of getting the images related to the partogram content using the intrapartum ultrasound. Methods One hundred twenty-three pregnant women who tried vaginal delivery in Huai'an Maternity and Children Hospital were included in this study. Intrapartum ultrasound was performed during the progression of labor every two hours. To obtain the images related to the fetal position by transabdominal or transperineal ultrasound in transverse view, determining the fetal head position; to obtain the images related to the fetal head station by transperineal ultrasound in mid-sagittal and transverse views , measuring the angle of progression (AOP) and the fetal head-perineum distance (HPD); to obtain the images related to the cervical dilatation by transperineal ultrasound in transverse view, measuring the anteroposterior diameter of the cervical dilatation. Results This study included 123 pregnant women, 123 images were obtained related to the fetal position; 122 images of AOP related to the fetal head station were measured; and 123 images of HPD related to the fetal head station were measured; 121 images related to the cervical dilatation, all the images can clearly displayed various ultrasonic markers, which can be used to determine the fetal position, the fetal head station and the cervical dilation. Conclusion Intrapartum ultrasound could get the images related to the partogram content, it could be studied to use in labor.