MFMU剖宫产登记:初次剖宫产后子宫收缩乏力

查看全文 作　　者：Rouse D. [1]J.;Leindecker [1]S.;Landon [1]M.;习艳霞(译)[2];高雪莲(校)[2] 机构地区：[1]Dr. D.J. Rouse, Departments of Obstetrics and Gynecology, Center for Research in Women's Health, University of Alabama at Birmingham, Birmingham, AL, United States;[2]不详 出　　处：《世界核心医学期刊文摘(妇产科学分册)》索引2006年第2卷第1期,共1页 摘　　要：The purpose of this study was to define independent risk factors for uterine atony after primary cesarean delivery, and to assess their overall association with atony in the study cohort. Study design: This was a 13- university center prospective observational study. All women who underwent primary cesarean from January 1, 1999 to December 31, 2000 were eligible. Trained and certified research nurses performed systematic data Abstraction. The definition of atony required both the clinical diagnosis and the use of methergine or a prostaglandin preparation. Risk factors for uterine atony were assessed in univariable and multivariable logistic regression analyses, and these analyses then used to inform an assessment of the association of the various risk factors with the occurrence of uterine atony in the overall cohort. Results: Twenty-three thousand, three hundred and ninety pregnancies were analyzed. Uterine atony occurred in 1416 women (6% ). Several variables were independently associated with atony in a multivariable model, including multiple gestation (odds ratio [OR] 2.40, 95% CI 1.95- 2.93), maternal Hispanic race (2.21, 1.90- 2.57), induced or augmented labor for >18 hours (2.23, 1.92- 2.60), infant birth weight >4500 g (2.05, 1.53- 2.69), and clinically diagnosed chorioamnionitis (1.80, 1.55- 2.09). However, because the various risk factors were not very powerful, approximately half of the cases of atony were associated with the 2/3 of women lacking a given risk factor or combination of risk factors. Conclusion: Although certain risk factors and uterine atony were clearly associated, the associations are of limited practical clinical use. 关 键 词：产后子宫收缩乏力 剖宫产 多元LOGISTIC回归分析 初次 独立危险因素 婴儿出生体重 队列研究 系统培训 观察性研究 子宫收缩剂