Comparative Analysis of Risk Factors for Postpartum Hemorrhage in Forceps-Assisted and Vacuum-Assisted Vaginal Deliveries

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2025-02-13 DOI:10.1155/ijcp/1538613

Hui Li, Yurong Jiang, Hua Pan

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引用次数: 0

Abstract

Objective: This study aims to compare the clinical outcomes of forceps-assisted vaginal delivery (FAVD) and vacuum-assisted vaginal delivery (VAVD) in primiparous women and to identify risk factors contributing to moderate and severe postpartum hemorrhage (PPH) associated with these delivery methods.

Methods: A retrospective analysis was conducted on clinical data from 1237 primiparous women who delivered at the Obstetrics Department of Hunan Maternal and Child Health Hospital between April 2018 and April 2022. Among these, 711 underwent FAVD and 526 underwent VAVD. Maternal and neonatal characteristics, including age, gestational age, prepregnancy body mass index (BMI), pregnancy weight gain, neonatal weight, and labor duration, were evaluated. The study assessed labor duration, neonatal weight, maternal complications, neonatal complications, and the incidence and severity of PPH. Binary logistic regression analysis was performed to identify risk factors for moderate (500–1000 mL blood loss) and severe (> 1000 mL blood loss) PPH associated with the two delivery methods.

Results: Compared with FAVD, VAVD was associated with a higher incidence of uterine atony (p < 0.05) and increased risks of both moderate and severe PPH (p < 0.05). Pregnant women with significant gestational weight gain more frequently underwent VAVD (p < 0.05), which also correlated with prolonged second and total labor stages compared with FAVD (p < 0.05). Logistic regression revealed that uterine atony was a significant risk factor for both moderate and severe PPH (p < 0.05). Prolonged total labor independently increased the risk of severe PPH in VAVD cases (p < 0.05 and OR 1.575), while gestational weight gain and prolonged labor were independent risk factors for moderate PPH in FAVD cases (p < 0.05, OR 1.047 and OR 1.287, respectively).

Conclusions: VAVD is associated with longer labor duration, a higher likelihood of PPH, and increased neonatal scalp hematoma incidence compared with FAVD. Prolonged total labor significantly contributes to moderate PPH risk in FAVD and severe PPH risk in VAVD. Uterine atony is an independent predictor of both moderate and severe PPH.

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产钳辅助与真空辅助阴道分娩产后出血危险因素比较分析

目的：本研究旨在比较产钳辅助阴道分娩（FAVD）和真空辅助阴道分娩（VAVD）在初产妇中的临床效果，并确定与这两种分娩方式相关的导致中重度产后出血（PPH）的危险因素。方法：回顾性分析2018年4月至2022年4月在湖南省妇幼保健院产科分娩的1237例初产妇的临床资料。其中FAVD 711例，VAVD 526例。评估产妇和新生儿的特征，包括年龄、胎龄、孕前体重指数（BMI）、孕期体重增加、新生儿体重和分娩时间。该研究评估了分娩时间、新生儿体重、产妇并发症、新生儿并发症以及PPH的发生率和严重程度。进行二元logistic回归分析，以确定中度（500-1000 mL失血）和重度(>；1000 mL失血)PPH与两种分娩方式相关。结果：与FAVD相比，VAVD有较高的子宫张力发生率(p <；0.05)，中度和重度PPH的风险均增加(p <；0.05)。妊娠期体重显著增加的孕妇更容易发生VAVD (p <；与FAVD相比，第二产程和总产程延长也有相关性(p <；0.05)。Logistic回归分析显示，子宫张力是中重度PPH的重要危险因素(p <；0.05)。总产程延长增加了VAVD患者发生严重PPH的风险(p <；0.05和OR 1.575)，而妊娠体重增加和延长产程是FAVD患者中度PPH的独立危险因素(p <；0.05, OR 1.047, OR 1.287)。结论：与FAVD相比，VAVD与分娩时间更长、PPH的可能性更高以及新生儿头皮血肿发生率增加有关。延长的总产程显著增加了FAVD的中度PPH风险和VAVD的重度PPH风险。子宫张力是中度和重度PPH的独立预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.