双胎妊娠一胎保留胎膜囊的剖宫产术对产后出血的影响

Effect of Cesarean Section with Membrane Sac Retention for One Fetus on Postpartum Hemorrhage in Twin Pregnancy

目的探讨双胎妊娠一胎保留胎膜囊的剖宫产术对产后出血的影响。方法选取新余市妇幼保健院2017年1月至2019年12月收治的双胎妊娠行剖宫产术的孕妇50例,按随机数字表法分为2组:试验组25例,术中一胎常规破膜后取出胎儿,另一胎保留胎膜囊,将胎膜囊与子宫内壁充分剥离,将胎膜囊内的胎儿及羊水完整地一并娩出;对照组25例,按传统方法分别破膜,吸尽羊水,依次取出胎儿。比较2组产后出血率及产后出血量。结果与对照组比较,试验组产后出血率明显降低,产后出血量明显减少,差异均有统计学意义(均P<0.05)。结论双胎妊娠一胎保留胎膜囊的剖宫产术可有效减少产后出血率及产后出血量。

Objective To investigate the effect of cesarean section with membrane sac retention for one fetus on postpartum hemorrhage in twin pregnancy.Methods A total of 50 women with twin pregnancy who underwent cesarean section in Xinyu Maternal and Child Health Care Hospital from January 2017 to December 2019 were randomly divided into two groups,with 25 women in each group.In the experimental group,one fetus was removed after routine rupture of the membrane,and membrane sac was kept in the other fetus.The membrane sac was fully peeled off from the endometrium,and the fetus and amniotic fluid in the membrane sac were completely delivered together.In the control group,the fetuses were removed after the membrane was conventionally ruptured and amniotic fluid was sucked out.The incidence and volume of postpartum hemorrhage were compared between the two groups.Results Compared with control group,the incidence and volume of postpartum hemorrhage significantly decreased in experimental group(P<0.05).Conclusion Cesarean section with membrane sac retention for one fetus in twin pregnancy can effectively reduce the incidence and volume of postpartum hemorrhage.