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| Analysis of the influencing factors of postpartum hemorrhage in pregnant women converted to cesarean section due to trial of vaginal labor |
| Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, Zhejiang Province，310007 |
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Abstract To analyze the influencing factors of postpartum hemorrhage in pregnant women who failed vaginal trial delivery and converted to cesarean section. Methods: The clinical data of 397 pregnant women who failed vaginal trial delivery and converted to cesarean section from June 2020 to December 2021 were selected retrospectively. According to whether postpartum hemorrhage occurred or not, these women were divided into group A (38 women with postpartum hemorrhage) and group B (359 women without postpartum hemorrhage). The influencing factors of postpartum hemorrhage of the women in group A were analyzed by multivariate logistic regression. Results: There were 38 (9.6%) women with postpartum hemorrhage in 397 women. Multivariate logistic regression analysis showed that long time of vaginal trial delivery (OR =6.450, 95%CI 2.427-10.635), the edema of lower segment of uterus and cervix (OR=5.168 95%CI 1.5636.948), the incision tear (OR=8.016, 95%CI 2.725-12.130), the coagulation disorders (OR=3.020, 95%CI 1.758-7.322), the neonatal weight (OR=5.037, 95%CI 2.014-9.386) of the women who had been converted to cesarean section after vaginal trial delivery failure were the risk factors of their postpartum hemorrhage (P＜0.05), and labor analgesia (OR=0.201, 95%CI 0.108-0.514) was a protective factor of their postpartum hemorrhage (P＜0.05). Conclusion: Some measure, such as monitoring and reasonably controlling fetal weight during pregnancy, correctly grasping the trial delivery time, scientifically using labor analgesia, and dynamically evaluating the progress of labor in the process of labor, can prevent or reduce the occurrence of the edema of soft birth canal, and can alert the occurrence of intraoperative uterine incision tear, which is helpful to prevent or reduce the occurrence of postpartum hemorrhage of the pregnant women who have failed vaginal trial delivery and converted to cesarean section.
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