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안면위에 있어서 임상적 연구
A Clinical Study on Face Presentation
오말례(ML Oh),전희숙(HS Chon),이진희(CH Lee),임완희(WH Lim),이수자(SJ Lee)
UCI I410-ECN-0102-2009-510-005407971

1. 안면위의 발생빈도는 0.24%(1 : 489)였다. 2. 대다수에서 확실한 원인은 발견할 수 없었고 확인된 원인 가운데서 가장 흔한것이 체중 2,500gm이 하, 태아기형, 태아근육강도의 변경이었다. 3. 전체 분만에서 경산모의 빈도가 52%인데, 비해 안면위를 나타낸 경산모의 빈도는 57%로 약간 더 높았다. 연령분포는 전체분만과 마찬가지로 20대에서 가장 높았다. 4. 임신주수분포는 37주와 40주사이가 57%로서 전체분만의 분포와 비슷했으나 과숙아는 전체분만분포 보다 2배로 높았다. 5. 산전관리를 받은 산모와 받지않은 산모사이에 발생빈도의 차이는 실제로 없었다. 6. 산전관리기간에 진단된 경우도 몇몇 있었으나 대다수 분만 제 1 기에 진단되었다. 7. 태아의 위치는 후위 하순기반 28.4%, 횡위 하순기반 22%, 전위 하순기반 47%였고 2예는 기록되지 않았다. 우사경이 좌사경보다 2배이상 높은 빈도를 보였다. 8. 분만방식은 자연분만이 47%, 감자분만 6%, 제왕절개술 47%였다. 같은 기간중 전체분만의 제왕절 개술 율은 10.0%였다. 제왕절개술의 필요성은 위치가 전위 하순기반으로 전환여부와 분만진행여부에 의해 결정된다. 9. 모성 이환율은 낮으며 모성사망은 없었고 2예의 자궁파열이 있었다. 불교정 주산기사망율은 26.6% 였으나 그중 태아기형이 반을 차지했고 교정 주산기사망율은 4.4%였다.

The purpose of this paper is to present the results of a clinical study on patients with face presentation who were delivered at Il Sin Women`s Hospital during the 10 years from Jaan 1971 to Dec. 1980. During that period face presentation occurred in 113 singleton pregnancies out of a total 55,301 deliveries and an analysis of the etiology, diagnosis, management and deliveries and an analysis of the etiology, diagnosis, management and delivery was done. The results were as follows; 1. the incidence of face presentation was 0.24% in 1 : 489 deliveries. 2. No definite cause could be found in the majority of the patients but of the causes that could be identified the most common were fetal weight less than 2,500 grms, fetal abnormality andalteration in the muscle tone of the fetus. 3. There was a higher incidence of multipara among women with face presentation, 57% being between 37 and 40 weeks, but the 14% incidence of post maturity was twice as high as oberall ncidence. 5. There was no real difference in the incidence of face presentation among those who had, and those who had not received antenatal care. 6. Some cases were diagnosed in the antenatal period but the majority, 56% were diagnosed during the first stage of labour. 7. The position of the fetus was mento posterior in 28.4% of the cases mento transverse in 22%, and mento anterior in 47%. In 2 cases the position was not recorded. the head engaged in the reght oblique diameter of the pelvis twice as often as in the left oblique diameter. 8. The method of delivery was spontaneous delivery(47%), cesarean section(47%) and forceps delivery 6%. The overall hospital cesaream section rate during this period was 10.0%. Necessity for cesarean section rate during this period was 10.0%. Necessity for cesarean section was determined by (1) whether the position converted to mento-anterior, and (2) whether progress was made in labour. 9. Maternal morbidity was low and no maternal deaths occurred, but there were 2 cases of uterine rupture. the oberall perinatal mortality was 26.6% but major fetal abnormalities were the cause of 50% of the deaths and the corrected perinatal loss was 4.4%.

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