|
|
Analysis of factors affecting the uterine atony which isn’t sensitive to uterotonic agents in cesarean section |
SUN Rongrong, ZHANG Wenmiao, XIAO Biru, CHEN Qiuyue |
Department of Obstetrics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015 |
|
Cite this article: |
SUN Rongrong,ZHANG Wenmiao,XIAO Biru, et al. Analysis of factors affecting the uterine atony which isn’t sensitive to uterotonic agents in cesarean section[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2017, 47(12): 910-913.
|
|
Abstract Objective: The purpose of this article was to identify risk factors and etiologiesleading to the uterine atony which wasn’t sensitive to uterotonic agents in cesarean section. Methods: The information of 705 patients who underwent caesarean delivery were collected between January 2014 and July 2016, who were divided into two groups based on the sensitivity of the uterotonic agents. Patients who were insensitive to uterotonic agents named group A (n=84, and the others named group B, n=621). Risk factors and etiologies for the uterine atony which wasn’t sensitive to uterotonic agents were explored using univariate and multivariate logistic regression analyses. Results: Multiple pregnancy (OR=6.495, 95%CI=3.801-11.098), adherent placenta (OR=2.865, 95%CI=1.595-5.144), placenta praevia (OR=4.096, 95%CI=1.912-8.660), general anesthesia (OR=1.470, 95%CI=1.198-1.803) were independently associated with the uterine atony which wasn’t sensitive to uterotonic agents. Conclusion: Multiple pregnancy, adherent placenta, placenta praevia and general anesthesia are the related factors of the uterine atony which isn’t sensitive to uterotonic agents should be pay attention to, we should take positive measures for the prevention and treatment.
|
Received: 10 March 2017
|
|
|
|
|
[1] ANDERSON F W. Maternal mortality: an enduring epidemic
[J]. Clin Obstet Gynecol, 2009, 52(2): 214-223.
[2] Nyflot L T, Sandven I, Stray-Pedersen B, et al. Risk factors for severe postpartum hemorrhage: a casecontrol study[J]. BMC Pregnancy Childbirth, 2017, 17(1): 17.
[3] MEHRABADI A, HUTCHEON J A, LEE L, et al. Epidemiological investigation of a temporal increase in atonic postpartum haemorrhage: a populationbased retrospective cohort study[J]. BJOG, 2013, 120(7): 853-862.
[4] BATEMAN B T, BERMAN M F, RILEY L E, et al. The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries[J]. Anesth Analg, 2010, 110(5): 1368-1373.
[5] 盛敏毅, 应豪, 段涛. 宫缩剂不敏感宫缩乏力性产后出血的诊治[J]. 实用妇产科杂志, 2013, 29(8): 564-565.
[6] ROSSEN J, OKLAND I, NILSEN O B, et al. Is there an increase of postpartum hemorrhage, and is severe hemorrhage associated with more frequent use of obstetric interventions? [J]. Acta Obstet Gynecol Scand, 2010, 89(10): 1248-1255.
[7] MEHRABADI A, LIU S, BARTHOLOMEW S, et al. Temporal trends in postpartum hemorrhage and severe postpartum hemorrhage in Canada from 2003 to 2010[J]. J Obstet Gynaecol Can, 2014, 36(1): 21-33.
[8] DRIESSEN M, BOUVIER-COLLE M H, DUPONT C, et al.
Postpartum hemorrhage resulting from uterine atony after vaginal delivery: factors associated withseverity[J]. Obstet Gynecol, 2011, 117(1): 21-31.
[9] 曹泽毅. 中华妇产科学[M]. 3版. 北京: 人民卫生出版社, 2014: 404-421.
[10] 程君君, 曹淑华, 陆艳. 宫缩乏力性产后出血的相关因素及护理干预[J]. 温州医学院学报, 2013, 2(2): 138-139.
[11] WETTA L A, SZYCHOWSKI J M, SEALS S, et al. Risk factors for uterine atony/postpartum hemorrhage requiring treatment after vaginal delivery[J]. Am J Obstet Gynecol, 2013, 209(1): 51.
[12] SKJELDESTAD F E, OIAN P. Blood loss after cesarean delivery: a registry-based study in Norway, 1999-2008[J]. Am J Obstet Gynecol, 2012, 206(1): 76.
[13] YOO K Y, LEE J C, YOON M H, et al. The effects of volatile anesthetics on spontaneous contractility of isolated human pregnant uterine muscle: a comparison among sevoflurane, desflurane, isoflurane, and halothane[J]. Anesth Analg, 2006, 103(2): 443-447. |
|
|
|