胎盤娩出法別分娩時出血量の比較  [in Japanese] Placental expulsion method in relation to incidence and volume of primary postpartum hemorrhage  [in Japanese]

Abstract

弛緩出血は分娩時出血性疾患のなかでもっとも危険度が高く,ときに致命的であり, 19世紀以降さまざまな処置法が考案されてきた。また,胎盤の娩出法については胎盤の確実な娩出と異常出血の予防を目的に,種々の方法が考案されてきた。今回,胎盤娩出法の違いが弛緩出血に起因する分娩時異常出血の予防に反映するのかを統計的に検討した。方法:出血量と弛緩出血発生率について,胎盤自然剥離後クレーデ法と胎盤自然剥離後ブラント・アンドリュース法を,胎盤早期剥離クレーデ法との間で比較検討した。結果:胎盤早期剥離クレーデ法に比較して胎盤自然剥離後クレーデ法では出血量や弛緩出血の発生が増加する傾向にあり,胎盤自然剥離後ブラント・アンドリュース法ではともに減少させうる傾向にあった。結論:分娩時異常出血の予防のため,ブラント・アンドリュース法による胎盤娩出が推奨されることが示された。

Introduction: The risk of atonic primary postpartum hemorrhage (PPH) is highest, sometimes even fatal, during labor. Since the 19th century, various methods have been devised and proven reliable for both the prevention of PPH and the safe expulsion of the placenta. In this study, we sought to examine differences between placental expulsion methods and the prevention of atonic PPH. Materials and methods: This study comprised 570 female patients divided into the following three groups based on the method of placental expulsion: Group A, in which the placenta was spontaneously delivered using the Brandt-Andrews technique of controlled cord traction; Group B, in which the placenta was spontaneously delivered using Crede's method; and Group C, in which the placenta was prematurely separated using Crede's method. Both the incidence and volume of PPH were then compared between groups. Results: Both the lowest rate of incidence and the smallest volume of atonic PPH were observed in Group A. Conversely, the highest rate of incidence and the largest volume of atonic PPH were observed in Group C. Conclusion: These results suggest that the Brandt-Andrews technique using controlled cord traction is recommended for placental expulsion in order to promote the prevention of PPH.

Journal

Maternal health   [List of Volumes]

Maternal health 54(2), 311-316, 2013-07  [Table of Contents]

Japan Society of Maternal Health

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Codes

  • NII Article ID (NAID) :
    110009624954
  • NII NACSIS-CAT ID (NCID) :
    AN0022863X
  • Text Lang :
    JPN
  • ISSN :
    03881512
  • NDL Article ID :
    024794644
  • NDL Call No. :
    Z19-1016
  • Databases :
    NDL  NII-ELS 

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