【摘要】 目的 了解初产妇妊娠≥41周胎头未固定者其剖宫产的危险性。方法 将330例妊娠≥41周的孕妇分为3组,其中初产妇胎头未固定者为A组共126例,胎头已固定者为B组共98例，经产妇为C组共106例, 3组孕妇入院后确定胎先露位置，产程开始时间, 进行宫颈Bishop评分,记录分娩的方式及剖宫产的指征。结果 初产妇妊娠41周以上胎头未固定者其剖宫产的危险性明显增高，在宫颈评分，通过引产临产、剖宫产方面与B组及C组比较差异有非常显著性(P<0.01)，B组与C组比较差异无显著性(P>0.05)。结论 加强对延期妊娠孕妇的监护，对初产妇妊娠≥41周胎头未固定者应严密观察产程进展，及早做好剖宫产准备。

    【关键词】 延期妊娠； 胎头； 剖宫产

    The risk of cesarean deliver in pregnant primipara of over 41 weeks with unfixed fetal head

    LI jing-lin.Department of Obstetrics and Gynecology , Dashi People’s Hospital of Fanyu,Guangzhou 511430,China

    【Abstract】 Objective To study the risk of the cesarean deliver in pregnant primipara of over 41 weeks with unfixed fetal head. Methods 330 cases of pregnant women of over 41 weeks were divided into three groups, Group A includes 126 cases of pregnant primipara with unfixed fetal head ; Group B includes 98 cases of those with fixed fetal head. Group C includes 106 cases of multipara. The position of fetus present and the time of onset of labor of all pregnant women were determined after their admission. The Bishop scores of cervix were conducted, the delivery way and the signs of cesarean deliver were also recorded. Results The risk of cesarean deliver in pregnant primipara of over 41 weeks with unfixed fetal head increased dramatically . There was significant difference between group A and group B or group C in the Bishop scores of cervix together with the risk of induced abortion and cesarean deliver(P<0.01). But no difference was found between group B and group C(P>0.05). Conclusion Strengthening monitor of delayed pregnant woman is necessary, the birth process of pregnant primipara of over 41 weeks with unfixed fetal head should be carefully observed, good preparation for cesarean deliver should be made as early as possible. ......