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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >Manual removal versus spontaneous delivery of the placenta at cesarean section in developing countries: a randomized controlled trial and review of literature
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Manual removal versus spontaneous delivery of the placenta at cesarean section in developing countries: a randomized controlled trial and review of literature

机译：手动去除与发展中国家剖宫产的胎盘自发递送：随机对照试验和文学审查

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Purpose: Cesarean section (CS) rates have increased; this is especially concerning in developing countries. The mode of placental delivery contributes to morbidity associated with CS and determines blood loss during CS. We aimed to compare manual removal versus spontaneous delivery of the placenta at CS.Methods: In a randomized controlled trial, 574 women admitted for primary or repeat elective CS were randomized into two groups. In group A, the placenta was manually removed, whereas in group B, the placenta was left for spontaneous delivery. Blood loss, operative and postoperative data were recorded.Results: Blood loss was 875.2524.2ml in group A versus 731.8 +/- 426.7ml in group B (p=.001), with a significant drop in postoperative HB (p=.015) and HCT (p=.031). In group A, odds ratios for blood loss (1000ml), HB drop (4g/dl), postpartum hemorrhage and blood transfusion were 2.581, 2.850, 2.614 and 1.665, respectively. However, the total operative time (p=.326), duration of hospital stay (p=.916) and intensive care unit (ICU) admission (p=.453) were not statistically different between the two groups.Conclusions: Manual removal of the placenta at CS is associated with a higher risk of blood loss, postpartum hemorrhage and blood transfusion, with no decrease in operative time.
机译：目的：剖宫产（CS）率增加;这尤其是在发展中国家。胎盘递送模式有助于与CS相关的发病率，并确定CS期间的血液损失。我们的旨在比较手动去除与CS的胎盘自发递送在A组中，手动除去胎盘，而在B组中，胎盘留下自发递送。记录血液损失，手术和术后数据。结果：B组（P = .001）组中的731.8 +/- 426.7ml中的失血量为875.2524.2ml。术后HB（P = .015）下降）和hct（p = .031）。在A组中，失血（＆ 1000ml），Hb下降（＆ 4g / dl），产后出血和输血分别为2.581,2.850,2.614和1.665。但是，总操作时间（P = .326），住院期间的持续时间（P = .916）和重症监护单元（ICU）入场（P = .453）在两组之间没有统计学不同.Conclusions：手动移除在CS的胎盘与血液损失，产后出血和输血的风险较高有关，操作时间没有减少。

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