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胎盘脐带引流在第三产程管理中的作用:一项多中心随机对照研究。

Influence of placental cord drainage in management of the third stage of labor: a multicenter randomized controlled study.

作者信息

Asicioglu Osman, Unal Canan, Asicioglu Berhan Besimoglu, Temizkan Osman, Yildirım Gokhan, Arici Bulent, Gulova Sibel

机构信息

Department of Obstetrics and Gynecology, Şişli Etfal Education and Research Hospital, Istanbul, Turkey.

Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.

出版信息

Am J Perinatol. 2015 Mar;32(4):343-50. doi: 10.1055/s-0034-1384639. Epub 2014 Aug 11.

Abstract

OBJECTIVE

The aim of this study is to assess the effect of placental drainage during active management of the third stage of labor on reducing both blood loss and the length of the third stage.

STUDY DESIGN

This prospective randomized controlled trial included 485 patients who underwent vaginal delivery in two tertiary hospital. Subjects were randomly allocated to the cord drainage group, in which the cord was unclamped after cutting (n = 242), or the control group, in which the cord was left clamped (n = 243). The primary outcome was mean blood loss during the third and fourth stages of labor.

RESULTS

The mean estimated blood loss was significantly lower in the cord drainage group than in the control group (207.04 ± 123.3 vs. 277.63 ± 246.9 mL, respectively; p ˂ 0.001). The third stage of labor was significantly shorter in the cord drainage group than in the control group (3.5 ± 1.9 vs. 7.7 ± 3.4 minutes, respectively; p ˂ 0.001). No adverse events occurred during the cord drainage period.

CONCLUSION

Active management of the third stage of labor with the cord drainage method significantly reduced postpartum blood loss and the duration of the third stage.

摘要

目的

本研究旨在评估第三产程积极处理中胎盘引流对减少失血及缩短第三产程时长的效果。

研究设计

这项前瞻性随机对照试验纳入了485例在两家三级医院经阴道分娩的患者。受试者被随机分配至脐带引流组(n = 242),即切断脐带后不夹紧脐带,或对照组(n = 243),即夹紧脐带。主要结局是第三和第四产程期间的平均失血量。

结果

脐带引流组的平均估计失血量显著低于对照组(分别为207.04 ± 123.3 vs. 277.63 ± 246.9 mL;p ˂ 0.001)。脐带引流组的第三产程明显短于对照组(分别为3.5 ± 1.9 vs. 7.7 ± 3.4分钟;p ˂ 0.001)。脐带引流期间未发生不良事件。

结论

采用脐带引流法对第三产程进行积极处理可显著减少产后失血量及缩短第三产程时长。

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