通过一种安全可靠且具有可控制性的技术手段来有效地控制牵拉胎儿脐带对于第三产程持续时间长短、产后早期出血量、人工剥离胎盘以及胎盘残留情况的影响。方法:将2021年2月至6月在我院顺产分娩的400例病情稳定的低危产妇随机分为实验组...通过一种安全可靠且具有可控制性的技术手段来有效地控制牵拉胎儿脐带对于第三产程持续时间长短、产后早期出血量、人工剥离胎盘以及胎盘残留情况的影响。方法:将2021年2月至6月在我院顺产分娩的400例病情稳定的低危产妇随机分为实验组和对照各200例,实验组胎儿娩出后由高年资助产士采用可控性牵拉脐带的方法协助胎盘娩出;对照组在胎儿娩出后出现胎盘剥离征象时按常规娩出胎盘。两组均在胎儿娩出后立即给予乳林格500ml+缩宫素20iu静脉滴入。比较两组产妇第三产程时间、产时出血量、产后2小时出血量、人工剥离胎盘以及胎盘残留的情况。结果:实验组第三产程的持续时间(2.8±2.2) min ,明显比对照组(4.8±2.6) min ;实验组产后2h 的出血总量(205.5±180.6) ml ,少于对照组(280.8±220.2) ml ;人工剥离胎盘所发生的例数13例(6.8%)均明显低于对照组21例(10.5%),而胎盘残留情况两组无明显差别(P>0.05)。结论:胎儿娩出后及时有效的进行可控性牵拉脐带协助胎盘娩出可缩短第三产程,减少产后出血的,降低人工剥离胎盘数,且不会造成胎盘残留率的增加。展开更多
To investigate whether manual removal of the placenta is associated with significant blood loss compared with spontaneous separation of the placenta during cesarean delivery. A randomized prospective study of 400 wome...To investigate whether manual removal of the placenta is associated with significant blood loss compared with spontaneous separation of the placenta during cesarean delivery. A randomized prospective study of 400 women with normal pregnancies undergoing cesarean delivery at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Patients were randomly assigned to the study group, (manual placental removal, n=200) or the control group (spontaneous placental separation, n=200). Operative blood loss was assessed by the volumetric and gravimetric methods. Hemoglobin levels were evaluated the third postoperative day and patient s postoperative complications were recorded. The mean± S.D. amount of blood loss associated with manual and spontaneous removal of the placenta was 713± 240 and 669± 253 ml, respectively. This difference was statistically significant (P=0.04). There was a postoperative decrease in hemoglobin levels in both groups. Preoperative hemoglobin levels were 11.6± 3 g/dl in the study group and 11.2± 1.1 g/dl in the control group, and the difference was statistically significant (P=0.006). The postoperative hemoglobin levels at day 3 were 9.0± 1.2 g/dl in the study group and 9.9± 1.2 g/dl in the control group (P=0.003), also a statistically significant difference. The incidence of endometritis, wound infection, and need for blood transfusion was similar in the two groups. Manual delivery of the placenta was significantly associated with greater operative blood loss and greater decrease in postoperative hemoglobin levels, but with shorter operative time compared with spontaneous placental separation. No difference in postoperative complications was noted between the groups.展开更多
文摘通过一种安全可靠且具有可控制性的技术手段来有效地控制牵拉胎儿脐带对于第三产程持续时间长短、产后早期出血量、人工剥离胎盘以及胎盘残留情况的影响。方法:将2021年2月至6月在我院顺产分娩的400例病情稳定的低危产妇随机分为实验组和对照各200例,实验组胎儿娩出后由高年资助产士采用可控性牵拉脐带的方法协助胎盘娩出;对照组在胎儿娩出后出现胎盘剥离征象时按常规娩出胎盘。两组均在胎儿娩出后立即给予乳林格500ml+缩宫素20iu静脉滴入。比较两组产妇第三产程时间、产时出血量、产后2小时出血量、人工剥离胎盘以及胎盘残留的情况。结果:实验组第三产程的持续时间(2.8±2.2) min ,明显比对照组(4.8±2.6) min ;实验组产后2h 的出血总量(205.5±180.6) ml ,少于对照组(280.8±220.2) ml ;人工剥离胎盘所发生的例数13例(6.8%)均明显低于对照组21例(10.5%),而胎盘残留情况两组无明显差别(P>0.05)。结论:胎儿娩出后及时有效的进行可控性牵拉脐带协助胎盘娩出可缩短第三产程,减少产后出血的,降低人工剥离胎盘数,且不会造成胎盘残留率的增加。
文摘To investigate whether manual removal of the placenta is associated with significant blood loss compared with spontaneous separation of the placenta during cesarean delivery. A randomized prospective study of 400 women with normal pregnancies undergoing cesarean delivery at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Patients were randomly assigned to the study group, (manual placental removal, n=200) or the control group (spontaneous placental separation, n=200). Operative blood loss was assessed by the volumetric and gravimetric methods. Hemoglobin levels were evaluated the third postoperative day and patient s postoperative complications were recorded. The mean± S.D. amount of blood loss associated with manual and spontaneous removal of the placenta was 713± 240 and 669± 253 ml, respectively. This difference was statistically significant (P=0.04). There was a postoperative decrease in hemoglobin levels in both groups. Preoperative hemoglobin levels were 11.6± 3 g/dl in the study group and 11.2± 1.1 g/dl in the control group, and the difference was statistically significant (P=0.006). The postoperative hemoglobin levels at day 3 were 9.0± 1.2 g/dl in the study group and 9.9± 1.2 g/dl in the control group (P=0.003), also a statistically significant difference. The incidence of endometritis, wound infection, and need for blood transfusion was similar in the two groups. Manual delivery of the placenta was significantly associated with greater operative blood loss and greater decrease in postoperative hemoglobin levels, but with shorter operative time compared with spontaneous placental separation. No difference in postoperative complications was noted between the groups.
