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Resumen ANTECEDENTES: durante el embarazo el feto adopta diversas posturas en relación con su situación, presentación y posición, que hacen que la estática fetal sea cambiante. OBJETIVO: determinar la estática fetal durante el embarazo mediante la frecuencia de la situación, presentación y posición fetales, e identificar los factores predisponentes que condicionan estos cambios. MATERIALES Y MÉTODOS: estudio transversal y analítico, del que se evaluaron los ultrasonidos efectuados en el Hospital Civil de Guadalajara Dr. Juan I. Menchaca, para valorar la estática fetal (situación, presentación y posición) y correlacionarlos con la edad materna, antecedentes obstétricos y localización placentaria. Para identificar los factores implicados en la estática fetal se utilizaron pruebas estadísticas como: media, X2 y razón de momios (RM). RESULTADOS: de 7500 ultrasonidos efectuados, la presentación fetal fue cefálica en 6,045 fetos, pélvica en 1177 y transversa en 278. Se registraron 3981 fetos en posición dorso-izquierda 3,026 en dorso-derecha y 493 en otros tipos. La placenta se visualizó en la cara anterior del útero en 3626, cara posterior en 2774, fúndica en 581, placenta previa en 89 y otros sitios en 430 casos. La edad gestacional promedio fue de 31 semanas. Al analizar los resultados se encontró que a menor edad gestacional mayor estática fetal anormal en mujeres iguales o mayores de 35 años de edad, con tres o más embarazos o antecedente de placenta previa (p<0.05). CONCLUSIONES: la edad materna igual o mayor de 35 años, edad gestacional pretérmino, multiparidad (≥ 3 nacimientos) y placenta previa se correlacionan con estática fetal anormal.
Abstract BACKGROUND: The fetus in the course of pregnancy adopts different positions regarding its situation, presentation and position, making the fetal static of the fetus is changing. OBJECTIVE: To know the fetal static throughout the pregnancy through the frequency of the fetal situation, presentation and position, identifying the factors that condition these changes. MATERIALS AND METHODS: An analytical cross-sectional study of 7500 ultrasounds performed at the Hospital Civil of Guadalajara Dr. Juan J. Menchaca, assessing fetal static (status, position or back and presentation), analyzing maternal age, obstetric history and placental location. It was used to identify possible factors that influence fetal static the mean, X2 and odds ratio (OR). RESULTS: The fetal presentation was cephalic in 6,045 fetuses, pelvic 1177 and transverse 278. In relation to the back, were left 3,981, right in 3026 and other types 493. The placenta was reported on the anterior face of uterus 3626, posterior face 2774, fundic 581, previous placentas 89 and other sites 430. The average gestational age was 31 weeks. When analyzing the results we found that at lower gestational age abnormal fetal statics were more frequent, as in women older than 35 years, three or more pregnancies and placenta previa history (p<0.05). CONCLUSIONS: Maternal age ≥ 35 years, preterm gestational age, multiparity (≥ 3 births) and the presence of a placenta previa are associated with a higher frequency of abnormal fetal static.
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Objective To investigate the natural rotation of the fetal head during labor when it was engaged by occiput transverse (OT) or occiput posterior(OP) positions.Methods A total of 1 013 parturients was included who had a singleton term gestation, vertex presentation, OT or OP position with cervical dilatation of ≤ 3 cm, and vaginal delivery.All parturients were delivered in Xiamen Hospital of Traditional Chinese Medicine during April 1 to December 31,2014.Cervical dilation, station, and fetal position of every delivery were systematically recorded.Main outcome was the cervical dilation and station of anterior rotation from OT or OP position.They were Stratified by cervical dilation every 2 cm since 4 cm into 4 ～ 5 cm, 6 ～7 cm, 8 ～9 cm, 10 cm;or were stratified by fetal head station every 1 cm since-2 (S-2) into S-1 , S0, S+1 , S+2 , S+3.The differences in anterior rotation rate, dilatation, and head station between OT and OP were analyzed.Results There were 850 OT and 407 OP with cervical dilatation of ≤≤ 3 cm.The rate of anterior rotation was 82.5 ％ (701/850) and 76.7 ％ (312/407), respectively.The constituent ratio of OT rotating into occiput anterior position (OA) at different dilatation was different with that of OP (x2 =260.93, P ＜ 0.01).The constituent ratio of OT rotating into OA at different fetal head station was different with that of OP (x2 =133.18, P ＜0.01).The cervical dilatation and fetal head station that make it easy for OT 's anterior rotation were 6 ～7 cm (OR =5.81 , 95％ CI :3.81 ～8.87), 8 ～9 cm(OR =4.99 ,95％ CI:3.19 ～7.83), and S+1(OR =3.01, 95％ CI: 1.99 ～4.54), S+2(OR =5.43, 95％ CI:3.53 ～ 8.35).The cervical dilatation and fetal head station that make it easy for OP 's anterior rotation were 6～7 cm(OR =4.11,95％ CI :2.24 ～7.89), 8 ～9 cm(OR =27.31, 95％ CI :15.12 ～49.34), 10 cm(OR =27.76 , 95％ CI :14.87 ～51.82), S+2(OR =4.84 , 95％ CI :3.03 ～7.73).Conclusions The anterior rotation time of OT is different from OP.It's easy for OT to rotate into OA when cervix dilate into 6 ～9 cm and fetal head station is at S+1 ～ S+2.When cervix dilate into 6 ～ 10 cm and fetal head station is at S+2, it's easy for OP to rotate into OA.
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Objective To evaluate the methods and predictive values of obstetric conjugata measured by ultrasound.Methods A total of 200 women at 37～42 week's gestation,delivering a singleton infant and having an ultrasound examination within three days before delivery were studied.The obstetric conjugata,fetal biparietal diameter(BPD),fetal clavicula were measured by ultrasound,and compared with the obstetric conjugata measured in operation,newborn BPD,and newborn clavicula.Results The parameters such as obstetric conjugata,BPD and clavicula had no significant difference between ultrasonic measurement and actual measurement.When the obstetric conjugata and BPD difference