自然分娩初产妇产后盆腔脏器脱垂的影响因素

Influencing factors of postpartum pelvic organ prolapse in primiparas with natural delivery

目的:分析自然分娩初产妇产后盆腔脏器脱垂(POP)的影响因素。方法:回顾性分析2018年10月至2021年5月该院收治的80例自然分娩初产妇的临床资料。采用Logistic回归分析自然分娩初产妇产后POP的影响因素。结果:80例自然分娩初产妇中,产后发生POP 12例,占15.00%;发生POP产妇的产前体质量指数、流产史、孕期增重、妊娠期高血压、妊娠期糖尿病、总产程时间、分娩镇痛、会阴侧切及产后首次下床时间与未发生POP产妇比较,差异均无统计学意义(P>0.05);发生POP产妇的第二产程时间>1 h、新生儿体质量≥4 kg、盆腔手术史、产钳助产占比均高于未发生POP产妇,差异有统计学意义(P<0.05);Logistic回归分析结果显示,第二产程时间>1 h、新生儿体质量≥4 kg、盆腔手术史、产钳助产均为影响自然分娩初产妇产后发生POP的独立危险因素。结论:第二产程时间>1 h、新生儿体质量≥4 kg、盆腔手术史、产钳助产均为影响自然分娩初产妇产后发生POP的独立危险因素。

Objective:To analyze influencing factors of postpartum pelvic organ prolapse(POP)in primiparas with natural delivery.Methods:The clinical data of 80 primiparas admitted to our hospital from October 2018 to May 2021 were retrospectively analyzed.Logistic regression was used to analyze the influencing factors of postpartum POP in the primiparas with natural delivery.Results:Among the 80 primiparas with natural delivery.12 cases of POP occurred,accounting for 15.00%.There were no statistical differences in the prenatal body mass index,history of miscarriage,weight gain during pregnancy,gestational hypertension,gestational diabetes mellitus,total labor time,labor analgesia,episiotomy and postpartum first ambulation time of the primiparas with POP and those without POP(P>0.05).The proportions of the primiparas with the time of the second stage of labor>1 h,neonatal weight≥4 kg,history of pelvic surgery,and forceps deliver were higher than those without POP,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the time of the second stage of labor>1 h,neonatal weight≥4 kg,history of pelvic surgery,and forceps delivery were the independent risk factors of postpartum POP in the primiparas with natural delivery.Conclusions:The time of the second stage of labor>1 h,neonatal weight≥4 kg,history of pelvic surgery,and forceps delivery are the independent risk factors of postpartum POP in the primiparas with natural delivery.