Shripad Hebbar, Rai Lavanya, Mohan Akshara
Additional Professor, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, Karnataka, India .
Professor, Department of Obstetrics and Gynaecology, KMC Manipal , Manipal University, Karnataka, India .
J Clin Diagn Res. 2014 Apr;8(4):OC01-4. doi: 10.7860/JCDR/2014/7417.4208. Epub 2014 Apr 15.
To compare third stage blood loss in induced vs. spontaneous vaginal deliveries and to correlate the amount of blood loss with the decrease in haemoglobin following deliveries.
Department of Obstetrics and Gynaecology, Kasturba Hospital Manipal, Karnataka, India.
Blood loss following placental deliveries was measured by using special collection bags in 150 pregnant ladies who delivered vaginally by labour induction and it was compared with that of another 50 women who had spontaneous vaginal deliveries. Haemoglobin values were recorded for each patient prior to labour and after delivery of child.
The mean blood loss in induced group was 30 mL more than that in spontaneous group (202 ± 117 mL vs. 172 ± 114 mL), but this was not statistically significant (p=0.12). However, when different methods of induction were compared, oxytocin group was found to have significantly higher blood loss (327 ± 140 mL) as compared to that in other types of labour inductions as well as spontaneous deliveries. Labour induction using prostaglandins did not produce more blood loss as compared that produced by spontaneous deliveries. Both induced and spontaneous delivery groups showed statistically significant drops in post-delivery haemoglobin values, but the drop was relatively more in induced group as compared to that in spontaneous vaginal delivery group (0.96gm/dL vs. 0.56gm/dL), which appeared to be statistically significant (p=0.002).
Labour induction using prostaglandins is safe as compared to oxytocin usage. Accurate estimation of blood loss is important in all types of deliveries, in order to detect postpartum haemorrhage early, so that appropriate measures can be undertaken.
比较引产与自然阴道分娩的第三产程失血量,并将失血量与分娩后血红蛋白的下降情况进行关联分析。
印度卡纳塔克邦马尼帕尔卡斯图尔巴医院妇产科。
使用特殊收集袋测量150例引产阴道分娩的孕妇胎盘娩出后的失血量,并与另外50例自然阴道分娩的妇女的失血量进行比较。记录每位患者分娩前和分娩后的血红蛋白值。
引产组的平均失血量比自然分娩组多30毫升(202±117毫升对172±114毫升),但差异无统计学意义(p=0.12)。然而,比较不同的引产方法时,发现催产素组的失血量明显高于其他类型的引产以及自然分娩组(327±140毫升)。与自然分娩相比,使用前列腺素引产并没有导致更多的失血量。引产组和自然分娩组产后血红蛋白值均有统计学意义的下降,但引产组的下降幅度相对自然阴道分娩组更大(0.96克/分升对0.56克/分升),差异具有统计学意义(p=0.002)。
与使用催产素相比,使用前列腺素引产是安全的。在所有类型的分娩中准确估计失血量对于早期发现产后出血很重要,以便能够采取适当的措施。