Clinical Outcomes of Anterior Asynclitism Deliveries in a District-Level Hospital: Insights for Primary Care Obstetrics

Background: Anterior asynclitism, a rare but high-risk obstetric dystocia, disrupts normal fetal descent and is associated with increased maternal and neonatal complications. Despite its clinical significance, early diagnosis remains challenging due to nonspecific symptoms, and the associated risk factors require further clarification. Methods: A retrospective analysis was conducted on clinical data of 96 pregnant women with anterior asynclitism (observation group) and 96 pregnant women with persistent occipital transverse position (control group) from January 2017 to January 2023. Differences between the two groups across various aspects were compared and analyzed, and logistic regression analysis was used to determine the independent risk factors for the occurrence of anterior asynclitism. Results: In terms of high-risk factors, the incidences of macrosomia, obesity, and pendulous abdomen were significantly higher in the observation group than those in the control group (p < 0.05). Through regression analysis, age, macrosomia, obesity, pendulous abdomen, and premature rupture of membranes (PROM) were identified as independent risk factors for anterior asynclitism (p < 0.05). Regarding clinical symptoms, as well as maternal and neonatal outcomes, the incidences of PROM, cervical edema, fetal head edema, abnormal fetal monitoring, risk of uterine rupture, difficulty in delivering the fetal head, neonatal asphyxia, and intracranial hemorrhage in the observation group were all higher than those in the control group (p < 0.05). Conclusions: A three-tier prevention strategy is recommended: prenatal screening for key risk factors (pendulous abdomen, obesity), enhanced intrapartum monitoring combined with referral systems, and implementation of standardized surgical protocols. This study provides localized evidence for regional hospitals and underscores the need to prioritize obstetric technologies to narrow outcome gaps across healthcare tiers.