阴道分娩后子宫下段产后出血的早期识别和保守治疗。

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Xiao Liu, Yan Kang, Nannan Cao, Xiaomei Sun, Yongzhong Gu, Xietong Wang, Hongmei Wang
{"title":"阴道分娩后子宫下段产后出血的早期识别和保守治疗。","authors":"Xiao Liu, Yan Kang, Nannan Cao, Xiaomei Sun, Yongzhong Gu, Xietong Wang, Hongmei Wang","doi":"10.1080/14767058.2024.2386081","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study examined the efficacy of pulling down the cervix and packing it in the vaginal fornix (PC-PVF) on postpartum hemorrhage in the lower uterine segment (PPH-LUS).</p><p><strong>Methods: </strong>All cases of PPH-LUS after vaginal delivery at two tertiary hospitals between January 2019 and December 2022 were retrospectively investigated. Patients treated successfully with conservative measures were divided into routine treatment only (40 patients), routine treatment + early PC-PVF (33 patients), and routine treatment + late PC-PVF (51 patients) groups. Routine treatment consisted of uterine massage, uterotonics, and tranexamic acid administration. The therapeutic effect was evaluated by comparing the volume and rate of bleeding within 24 h after delivery.</p><p><strong>Results: </strong>A total of 124 patients were treated conservatively, except for three patients who underwent laparotomy for hemostasis after PC-PVF failed for incomplete rupture of the lower uterine segment. The efficacy of treatment was 44% (40/91) for routine treatment only and 100% when combined with PC-PVF for PPH-LUS. There was no significant difference in maternal age, gestational week, neonatal weight, and Apgar score. But the total blood loss in the conventional treatment + early PC-PVF group (657.27 ml ± 131.61 ml) was significantly lower than that in the other two groups, which was 847.13 ml ± 250.37 ml(<i>p</i> < .01) and 1040.78 ml ± 242.70 ml (<i>p</i> < .01), respectively. The bleeding rate in the routine treatment + early PC-PVF group decreased significantly after tamponade.</p><p><strong>Conclusions: </strong>PC-PVF is a safe and effective treatment for PPH-LUS. Early identification of PPH-LUS and prompt application of PC-PVF can effectively reduce blood loss after vaginal delivery.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2386081"},"PeriodicalIF":1.7000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early identification and conservative treatment of postpartum hemorrhage in the lower uterine segment after vaginal delivery.\",\"authors\":\"Xiao Liu, Yan Kang, Nannan Cao, Xiaomei Sun, Yongzhong Gu, Xietong Wang, Hongmei Wang\",\"doi\":\"10.1080/14767058.2024.2386081\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study examined the efficacy of pulling down the cervix and packing it in the vaginal fornix (PC-PVF) on postpartum hemorrhage in the lower uterine segment (PPH-LUS).</p><p><strong>Methods: </strong>All cases of PPH-LUS after vaginal delivery at two tertiary hospitals between January 2019 and December 2022 were retrospectively investigated. Patients treated successfully with conservative measures were divided into routine treatment only (40 patients), routine treatment + early PC-PVF (33 patients), and routine treatment + late PC-PVF (51 patients) groups. Routine treatment consisted of uterine massage, uterotonics, and tranexamic acid administration. The therapeutic effect was evaluated by comparing the volume and rate of bleeding within 24 h after delivery.</p><p><strong>Results: </strong>A total of 124 patients were treated conservatively, except for three patients who underwent laparotomy for hemostasis after PC-PVF failed for incomplete rupture of the lower uterine segment. The efficacy of treatment was 44% (40/91) for routine treatment only and 100% when combined with PC-PVF for PPH-LUS. There was no significant difference in maternal age, gestational week, neonatal weight, and Apgar score. But the total blood loss in the conventional treatment + early PC-PVF group (657.27 ml ± 131.61 ml) was significantly lower than that in the other two groups, which was 847.13 ml ± 250.37 ml(<i>p</i> < .01) and 1040.78 ml ± 242.70 ml (<i>p</i> < .01), respectively. The bleeding rate in the routine treatment + early PC-PVF group decreased significantly after tamponade.</p><p><strong>Conclusions: </strong>PC-PVF is a safe and effective treatment for PPH-LUS. Early identification of PPH-LUS and prompt application of PC-PVF can effectively reduce blood loss after vaginal delivery.</p>\",\"PeriodicalId\":50146,\"journal\":{\"name\":\"Journal of Maternal-Fetal & Neonatal Medicine\",\"volume\":\"37 1\",\"pages\":\"2386081\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Maternal-Fetal & Neonatal Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14767058.2024.2386081\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Maternal-Fetal & Neonatal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14767058.2024.2386081","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

研究目的本研究探讨了拉下宫颈并在阴道穹窿处填塞(PC-PVF)对产后子宫下段出血(PPH-LUS)的疗效:回顾性调查两家三甲医院2019年1月至2022年12月期间所有阴道分娩后PPH-LUS病例。将保守治疗成功的患者分为仅常规治疗组(40例)、常规治疗+早期PC-PVF组(33例)和常规治疗+晚期PC-PVF组(51例)。常规治疗包括子宫按摩、子宫收缩剂和服用氨甲环酸。通过比较产后 24 小时内的出血量和出血率来评估治疗效果:共有 124 名患者接受了保守治疗,只有 3 名患者因子宫下段不完全破裂,在 PC-PVF 失败后接受了开腹止血手术。仅常规治疗的有效率为 44%(40/91),结合 PC-PVF 治疗 PPH-LUS 的有效率为 100%。产妇年龄、孕周、新生儿体重和阿普加评分均无明显差异。但常规治疗 + 早期 PC-PVF 组的总失血量(657.27 毫升 ± 131.61 毫升)明显低于其他两组(847.13 毫升 ± 250.37 毫升)(P P 结论):PC-PVF是治疗PPH-LUS安全有效的方法。早期识别 PPH-LUS 并及时应用 PC-PVF 可有效减少阴道分娩后的失血量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early identification and conservative treatment of postpartum hemorrhage in the lower uterine segment after vaginal delivery.

Objective: This study examined the efficacy of pulling down the cervix and packing it in the vaginal fornix (PC-PVF) on postpartum hemorrhage in the lower uterine segment (PPH-LUS).

Methods: All cases of PPH-LUS after vaginal delivery at two tertiary hospitals between January 2019 and December 2022 were retrospectively investigated. Patients treated successfully with conservative measures were divided into routine treatment only (40 patients), routine treatment + early PC-PVF (33 patients), and routine treatment + late PC-PVF (51 patients) groups. Routine treatment consisted of uterine massage, uterotonics, and tranexamic acid administration. The therapeutic effect was evaluated by comparing the volume and rate of bleeding within 24 h after delivery.

Results: A total of 124 patients were treated conservatively, except for three patients who underwent laparotomy for hemostasis after PC-PVF failed for incomplete rupture of the lower uterine segment. The efficacy of treatment was 44% (40/91) for routine treatment only and 100% when combined with PC-PVF for PPH-LUS. There was no significant difference in maternal age, gestational week, neonatal weight, and Apgar score. But the total blood loss in the conventional treatment + early PC-PVF group (657.27 ml ± 131.61 ml) was significantly lower than that in the other two groups, which was 847.13 ml ± 250.37 ml(p < .01) and 1040.78 ml ± 242.70 ml (p < .01), respectively. The bleeding rate in the routine treatment + early PC-PVF group decreased significantly after tamponade.

Conclusions: PC-PVF is a safe and effective treatment for PPH-LUS. Early identification of PPH-LUS and prompt application of PC-PVF can effectively reduce blood loss after vaginal delivery.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.40
自引率
0.00%
发文量
217
审稿时长
2-3 weeks
期刊介绍: The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信