[Stress on the head of the fetus in spontaneous labor in relation to perinatal factors].

A Rempen
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Abstract

The pressure exerted on the fetal head during the second stage of labor was continuously measured in 42 spontaneous deliveries with a new instrument. The pressure values were correlated to various obstetric variables. Typically, the head pressure remained elevated beyond the end of the uterine contraction in primiparae, whereas it decreased simultaneously with the amniotic pressure in multiparae. On the average, the head pressure was higher in primiparae indicating, together with the longer lasting bearing down period, a higher resistance of the birth canal. Deliveries with pudendal block or peridural analgesia showed no differences, but these two groups differed in other factors which might have influenced the results. Infusion of oxytocin during the course of labor was associated with higher head pressure values that could not be deduced from the hormone administration per se, but from a higher resistance of the birth canal. Maternal age did not influence the head pressure. Within physiological limits, the head pressure was independent from the size of the child and the maternal pelvis.

自然分娩中胎儿头部压力与围生期因素的关系
用新仪器连续测量42例自然分娩时胎头压力。压力值与各种产科变量相关。一般来说,初产妇的头压在子宫收缩结束后仍然升高,而在多胎时,头压随羊膜压同时下降。平均而言,初产妇头部压力较高,加上持续压下时间较长,产道阻力较高。阴部阻滞或硬膜外镇痛的分娩没有差异,但两组在其他可能影响结果的因素上存在差异。在分娩过程中注入催产素与较高的头部压力值有关,这不能从激素的使用本身推断出来,而是从产道的更高阻力中推断出来的。产妇年龄对头部压力无影响。在生理范围内,头部压力与孩子和母亲骨盆的大小无关。
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