产钳助产围产结局及其产后出血高危因素分析

Analysis of perinatal outcome and risk factors of hemorrhage after forceps delivery

目的分析产钳助产围产结局及其发生产后出血的高危因素。方法回顾性分析2018年9月至2020年12月安徽医科大学第一附属医院经阴道分娩5044例产妇的临床资料,根据第二产程是否产钳助产,分为正常阴道分娩组(n=4858)与产钳助产组(n=186),并根据产钳助产产妇是否发生产后出血,分为产后出血组(n=54)与非产后出血组(n=132),采用logistic回归分析产后出血的高危因素。结果产钳助产组产后出血、严重会阴裂伤、尿潴留、新生儿窒息、颜面部擦伤夹痕及新生儿转重症监护室发生率高于正常阴道分娩组,差异有统计学意义(P<0.05)。助产胎方位、凝血功能异常和软产道裂伤是产钳助产发生产后出血的高危因素(P<0.05)。结论早期识别产钳产后出血的高危因素,积极防治,可有效降低产后出血发生率。

Objective To analyze the perinatal outcome of forceps and the risk factors of postpartum hemorrhage.Methods The clinical data of 5044 cases of vaginal delivery in the First Affiliated Hospital of Anhui Medical University from September 2018 to December 2020 were retrospectively analyzed.They were divided into normal vaginal delivery group(n=4858)and forceps delivery group(n=186)according to whether the second stage of labor was assisted by forceps.According to whether postpartum hemorrhage occurred in the women assisted by forceps,they were divided into postpartum hemorrhage group(n=54)and non-postpartum hemorrhage group(n=132),and the risk factors of postpartum hemorrhage were screened out by logistic regression analysis.Results The incidence of postpartum hemorrhage,severe perineal laceration,urinary retention,neonatal asphyxia,facial abrasions and neonatal transfer to intensive care unit in forceps group was significantly higher than that in normal vaginal delivery group(P<0.05).Fetal position,coagulopathy and soft birth canal lacerations were the risk factors for postpartum hemorrhage during forceps delivery.Conclusions Early identification of high risk factors of postpartum hemorrhage in forceps and active prevention and treatment can effectively reduce the incidence of postpartum hemorrhage.