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臀先露的胎儿娩出

Author
G Justus Hofmeyr, MD
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG
Translators
尹婕, 主治医师

引言

在有条件进行剖宫产的医疗单位，我们建议对单胎妊娠或双胎妊娠的第一胎避免臀位阴道分娩。对于符合安全阴道分娩选择标准且患者选择这一分娩方式的女性，阴道分娩是一种可接受的替代选择[1,2]。 (参见“臀先露概述”)

但甚至是在对臀先露有常规行剖宫产政策的机构，臀位阴道分娩也将会持续发生，因为如下情况：急产、院外分娩、严重的胎儿异常或死胎，以及孕妇优选采取阴道分娩。因此，临床医生继续掌握臀位分娩的技术很必要。

视频

在缺乏临床经验的情况下，诸如教学视频和人体模型的教学辅助资源可能是必要的[3]。以下模拟视频展示的是一位临床医生处理臀位阴道分娩时运用派珀尔(Piper)产钳取出后露胎头的方法(视频 1)。

展示臀位阴道分娩技术的免费视频也可在世界卫生组织(World Health Organization, WHO)生殖健康图书馆(Reproductive Health Library, RHL)的网站上在线观看[4]。

臀位阴道分娩

较乐观行臀位阴道分娩的标准 — 现已制定了许多种标准以最小化臀位阴道分娩的风险。这些选择患者的标准很大程度是基于临床经验，通常包括[5-9]：

                    

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Literature review current through: 2017-06 . | This topic last updated: 2017-02-03.
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