Schreiber Hanoch, Cohen Gal, Shalev-Ram Hila, Farladansky-Gershnabel Sivan, Weitzner Omer, Biron-Shental Tal, Kovo Michal, Arnon Shmuel, Markovitch Ofer
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428163, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel.
Children (Basel). 2023 Jul 12;10(7):1208. doi: 10.3390/children10071208.
Information on the effect of bloody amniotic fluid during labor at term is scarce. This study assessed risk factors and adverse outcomes in labors with bloody amniotic fluid. During the six years of this study, all nulliparas in our institution, with a trial of labor, were included. Multiple pregnancies and preterm deliveries were excluded. Outcomes were compared between the bloody amniotic fluid group and the clear amniotic fluid group. Overall, 11,252 women were included. Among them, 364 (3.2%) had bloody amniotic fluid and 10,888 (96.7%) had clear amniotic fluid. Women in the bloody amniotic fluid group were characterized by shorter duration of the second stage and higher rate of cesarean section due to non-reassuring fetal heart rate. In addition, there were higher rates of low cord pH (<7.1) and NICU admissions in the bloody amniotic fluid group. In multivariate logistic regression analysis, cesarean delivery, cord blood pH < 7.1, and NICU admission were independently associated with increased odds ratio for bloody amniotic fluid. Bloody amniotic fluid at term is associated with adverse outcomes and must be considered during labor.
关于足月分娩时血性羊水影响的信息很少。本研究评估了血性羊水分娩的危险因素和不良结局。在本研究的六年期间，纳入了我院所有进行试产的初产妇。排除多胎妊娠和早产。比较了血性羊水组和清亮羊水组的结局。总体而言，共纳入11252名女性。其中，364名（3.2%）有血性羊水，10888名（96.7%）有清亮羊水。血性羊水组的女性特点是第二产程时间较短，因胎儿心率异常而行剖宫产的比例较高。此外，血性羊水组脐带血pH值低（<7.1）和入住新生儿重症监护病房的比例也较高。在多因素逻辑回归分析中，剖宫产、脐带血pH<7.1和入住新生儿重症监护病房与血性羊水的比值比增加独立相关。足月血性羊水与不良结局相关，分娩期间必须予以考虑。
