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異狀胎位에 關한 臨床統計學的 考察

A Clinicaftharacteristics for Abnormal Presentation

대한산부인과학회지 1976년 19권 11호 p.785 ~ 791
金基元/Kim, K.W
趙潤元/金京泰/吳元燮/Choung, Y.W/Kim, K.T/Oh, W.S

Abstract


It has been well known that transverse lie was an uncommon complication of pregnancy but when it was present, it was often associated with conditions which made vaginal delivery harzardous for both fetus and mother.
Ninety cases of transverse lie were studied in obstetric unit of Catholic Medical College from January, 1970 to December, 1974.
During the period there were 41,272 deliveries, and we excluded multiple pregnant women in this study.
The results were as follows;
1) The incidence of transverse lie was one in 458 deliveries (0. 22%).
2) The age, distributions of mother were ranged from 19 years old to 43 years old and 70 per cent of all cases were developed onf multiparous (lI -N) women.
3) The most common clinical symptom was prolapse of the fetal part or umbilical cord (37 cases, 34.91%) and then impacted shoulder (23. cases, 21.70%), premature rupture of membrane (27 cases, 25.48%) and vaginal bleeding (19 cases, 17.93%) occurred.
4) The contributary factors were as follows; 20 cases of premature (22.2%), 16 cases of placenta previa (17.7%), 10 cases of multiparity (11. 1%), 3 cases of pelvic tumor and one case of uterine anomaly. 28 cases of multiparous women and 5 cases of nulliparous women were not cleared of their contibutary factors.
5) The management of transverse lie in orders were operative management (73 cases, 81. 1%), internal podalic version and breech extraction of the fetus ( Z cases, 7.8%), spontaneous delivery (7 cases, 7.8%) and destructive management ( 3 cases, 3.3%).
6) The methods of operation were as follows: 37 cases of lower segmental cesarean section (50.68%), 30 cases of cissical cesarean section (41. 10%) and 6 cases of cesarean hysterectomy (18.22%). Cesarean hysterectomy was performed in the cases of severe infection.
7) Maternal death was absent and 18 cases of perinatal mortality (20 %) was noticed including 15 cases of stillbirth. The causes of fetal death were prematurity, infection and asphyxia, etc.
8) Most of cases were not received antenatal care and over the four times of antenatal care were enforced on 4 cases of transverse lie.

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