子宫按摩对减少高危因素产后出血的效果观察

目的 探讨高危因素剖宫产术后子宫按摩对预防产后出血的效果.方法 选择剖宫产术后有子宫收缩乏力出血高危因素的产妇400例,随机分成观察组、对照组各200例.两组产妇均静脉滴注缩宫素,观察组产后2小时内每隔15分钟间歇按摩子宫1次,每次按压时间均以子宫恢复正常收缩,并能保护收缩状态,阴道流血减少为止.对照组按剖宫产术后2小时内每30分钟巡视检查子宫收缩和阴道出血情况.观察两组术后24h内出血量以及产后出血发生率的差异.结果 观察组的产后出血发病率明显低于对照组,24h出血量为（320±25）ml,对照组为（465±23）ml;对照组发生产后出血的主要原因为宫缩乏力,占产后出血的77.78%,其次为胎盘因素为22.22%.结论 子宫按摩加静脉滴注催产素对于控制高危妊娠产后出血以及减少产后出血量的效果明显,方法简单、安全,能有效促进产妇健康恢复.

Observation on the effect of decreasing postpartum hemorrhage by uterine massage in high risk pregnant women

Objective To observe the effect of lowing postpartum hemorrhage after cesarean section by uterine massage in high risk pregnant women.Methods 400 pregnant women with high risk of postpartum hemorrhage including uterine inertia after cesarean section were randomly divided into control group and observation group (200 case for each group).After baby delivery, they all received oxytocin by intravenous injection. Uterine massage was used in the observation group every 15 minutes within 2 hours after cesarean section, and the massage was given until the uterine contraction returned to normal and preserved to decrease vaginal bleeding. While only checking and recording the information of uterine contraction and vaginal bleeding in the control group every 30 minutes in 2 hours after cesarean section expect for giving oxytocin. The incidence and volume of the postpartum hemorrhage in two groups were obtained in 24 hours after cesarean section.Results The incidence and volume of the postpartum hemorrhage were significantly lower in observation group than that in control group. Conclusion It is markedly effective to control the incidence and volume of the postpartum hemorrhage by uterine massage and intravenous injection oxytocin after cesarean section in high risk pregnant women, which is simple and safe to promote recovery of the pregnant women.