Gynecology and Obstetrics, Mahdiyeh Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
J Matern Fetal Neonatal Med. 2021 Jan;34(2):287-292. doi: 10.1080/14767058.2019.1605351. Epub 2019 May 15.
Post-partum hemorrhage is a major cause of maternal mortality. Ultrasonography is a safe, rapid, and noninvasive diagnostic tool which can be used to identify and measure the abdomino-pelvic free fluid in post-partum period. This study was conducted to evaluate the risk factors and clinical significance of abdomino-pelvic free fluid after cesarean section. Demographic data, indication of cesarean section, duration of operation, volume of intraoperative blood loss, and instability in vital signs, blood transfusion, decreased Hb level, and decreased urine output were documented in 100 women with cesarean delivery 4 and 24 h after surgery. Abdomino-pelvic free fluid volume was estimated by ultrasound study. Four hours after cesarean, minimal, moderate, and large amount of free fluid was seen in 38(38%), 45(45%), and 17(17%) patients respectively. The volume of free fluid was decreased generally as 73 (73%) of patients had minimal amount of free fluid 24 h after surgery. There was statistically significant relationship between volume of blood loss during cesarean and the volume of free fluid 4 h (and not 24 h) after surgery. There was no statistically significant relationship between duration of operation and the volume of free fluid 4 and 24 h after cesarean. There is statistically significant relationship between free fluid volume 4 h after surgery and hemodynamic instability. Ultrasonography detects even minimal amount of free fluid in post-cesarean patients but cannot predict their clinical course.
产后出血是产妇死亡的主要原因。超声检查是一种安全、快速、无创的诊断工具，可用于识别和测量产后腹部和盆腔的游离液体。本研究旨在评估剖宫产术后腹部和盆腔游离液体的危险因素和临床意义。记录了 100 例行剖宫产术的妇女在术后 4 小时和 24 小时的人口统计学数据、剖宫产指征、手术持续时间、术中失血量、生命体征不稳定、输血、血红蛋白水平下降和尿量减少。通过超声检查评估腹部和盆腔游离液体量。剖宫产术后 4 小时，38%（38 例）、45%（45 例）和 17%（17 例）的患者分别出现少量、中量和大量游离液体。术后 24 小时，73%（73 例）的患者游离液体量减少，通常为少量。剖宫产术中失血量与术后 4 小时（而非 24 小时）游离液体量之间存在统计学显著关系。手术持续时间与术后 4 小时和 24 小时游离液体量之间无统计学显著关系。术后 4 小时游离液量与血流动力学不稳定之间存在统计学显著关系。超声检查可以检测到剖宫产术后患者的微量游离液体，但不能预测其临床病程。
