Department of Obstetrics and Gynecology, Maternal and Child health care hospital affiliated With Anhui Medical University, Anhui Maternal and Child health care Hospital, NO 15 Yimin Street, Hefei, 230000, China.
Arch Gynecol Obstet. 2024 Jan;309(1):159-166. doi: 10.1007/s00404-022-06861-1. Epub 2023 Jan 6.
To identify whether infection, cervical laceration and perineal laceration are associated with postpartum hemorrhage in the setting of vaginal delivery induced by Cook balloon catheter.
The retrospective study included 362 women who gave birth vaginally at or beyond 37 weeks of gestation with a diagnosis of postpartum hemorrhage between February 2021 to May 2022, of which including 216 women with induction of labor (Cook balloon catheter followed by oxytocin or oxytocin) and 146 women with spontaneous delivery. Risk factors for postpartum hemorrhage were collected and compared.
362 women were divided into three groups, group 1 with spontaneous delivery, group 2 with oxytocin, group 3 with Cook balloon catheter followed by oxytocin. There was no significant difference in incidence of infection within three groups (P > 0.05). The rate of cervical laceration and perineal laceration was significantly higher in group 3 compared with groups 2 and 1 (P < 0.05); Multivariate logistic regression analysis found that compared with group 1, either group 3 or group 2 was associated with increased risks of cervical laceration and perineal laceration (P < 0.05), and compared with group 2, group 3 was not associated with increased risks of cervical laceration and perineal laceration (P > 0.05).
Infection, cervical laceration and perineal laceration are identified not to be independent risk factors for postpartum hemorrhage for women undergoing labor with Cook balloon catheter; Cervical laceration and perineal laceration increase the risk of postpartum hemorrhage in women with labor induction.
确定 Cook 球囊导管诱导阴道分娩后,感染、宫颈裂伤和会阴裂伤是否与产后出血相关。
这项回顾性研究纳入了 2021 年 2 月至 2022 年 5 月期间 362 名经阴道分娩且孕周超过 37 周的产后出血产妇,其中 216 例为引产(Cook 球囊导管联合缩宫素或缩宫素),146 例为自然分娩。收集并比较了产后出血的危险因素。
362 名产妇分为三组,组 1 为自然分娩组,组 2 为缩宫素组,组 3 为 Cook 球囊导管联合缩宫素组。三组产妇感染率无显著差异(P>0.05)。组 3 的宫颈裂伤和会阴裂伤发生率明显高于组 2 和组 1(P<0.05);多因素 logistic 回归分析发现,与组 1 相比,组 3 或组 2 均与宫颈裂伤和会阴裂伤风险增加相关(P<0.05),与组 2 相比,组 3 与宫颈裂伤和会阴裂伤风险增加无关(P>0.05)。
感染、宫颈裂伤和会阴裂伤不是行 Cook 球囊导管分娩产妇产后出血的独立危险因素;宫颈裂伤和会阴裂伤增加了引产产妇产后出血的风险。