产科相关因素对产后盆腔器官脱垂的影响

Effect of obstetric related factors on postpartum pelvic organ prolapse

目的探究产科相关因素对产后盆腔器官脱垂(POP)的影响,为临床预防女性POP的发生提供依据。方法选取2013年6月-2016年6月该院收治住院的103例孕妇为研究对象,产后通过查阅病例收集孕妇年龄、产程、产次、合并疾病、分娩情况、胎儿体重等基线资料;采用女性盆腔器官脱垂定量检查(POP-Q)诊断患者POP发生情况;采用Logistics回归模型研究孕妇POP的发生因素。结果孕妇产后POP的发生率为47.57%,前壁脱垂30例(61.22%),后壁脱垂9例(18.37%),子宫脱垂10例(20.41%);Logistics回归分析显示,第二产程越长(OR=1.605)、阴道分娩(OR=3.684)、孕期体重指数(BMI)较高(OR=1.836)及胎儿体重较高(OR=2.542)是孕妇发生POP的危险因素。结论孕妇产后POP的发生率较高,孕妇第二产程越长、孕期BMI越高、胎儿体重越大是孕妇POP发生的危险因素。

Objective To explore the effect of obstetric related factors on postpartum pelvic organ prolapse（ POP）,provide a basis for clinical prevention of female POP. Methods A total of 103 hospitalized pregnant women admitted to the hospital were selected as research object from June 2013 to June 2016. The baseline information of these pregnant women,such as age,stages of labor,parity,complications,parturition status,fetal weight,was collected from case notes. The occurrence of POP in patients was diagnosed by quantification of female pelvic organ prolapse（ POP-Q）. Logistic regression model was used to explore the influencing factors of POP in pregnant women.Results The incidence rate of postpartum POP was 47. 57%,and there were 30 cases of anterior wall prolapse（ 61. 22%）,9 cases of posterior wall prolapse（ 18. 37%）,and 10 cases of uterine prolapse（ 20. 41%）. The results of logistic regression analysis showed that time extension of the second stage of labor（ OR = 1. 605）,vaginal labor（ OR = 3. 684）,maternal BMI during pregnancy（ OR = 1. 836）,and fetal weight（ OR = 2. 542） were the risk factors of POP in pregnant women. Conclusion The incidence rate of postpartum POP is high. Time extension of the second stage of labor,high BMI,and high fetal weight are the risk factors of POP in pregnant women.