A case-control analysis of perineal hematoma and its risk factors in pregnant women undergoing vaginal delivery / 中国实用护理杂志

ABSTRACT

Objective:To provide data support for preventing its occurrence and developing scientific and effective nursing intervention by investigating the situation and risk factors of perineal hematoma in pregnant women undergoing vaginal delivery through retrospective case-control study.Methods:A total of 102 parturients who had perineal hematoma during vaginal delivery in Shanghai Maternity and Infant Hospital Affiliated to Tongji University were selected as the hematoma group, from October 2018 to March 2020, and case control study ( n=204) was performed in the ratio of 1∶2. 24 possible influencing factors were determined by literature review and expert consultation and the data were collected retrospectively by clinicopathology. Single factor analysis, t test, Chi-square test and Multivariate binary Logistic regression analysis were used to identify factors related to perineal hematoma, and to explore potential risk factors of perineal hematoma. Results:From October 2018 to March 2020, there were 18 292 cases of vaginal delivery, including 102 cases of perineal hematoma, with an incidence of 0.56%. Single factor analysis showed 10 risk factors pertinent to perineal hematoma were selected ( t/ χ2 values were -4.51 to 31.79, all P<0.05); and multiple Logistic regression analysis showed the risk factors of perineal hematoma in vaginal delivery were old puerperal ( OR=7.53, P<0.05) and perineal edema ( OR=3.10, P<0.05), and the protective factors were free position delivery ( OR=0.35, P<0.05) and concomitant delivery ( OR=0.31, P<0.05). Conclusions:The incidence of perineal hematoma is relatively high in pregnant women undergoing vaginal delivery, usually occurrs on the right side of the perineal vagina and within 2 hours after delivery. Clinically, it is necessary to actively promote quality nursing services at midwifery to reduce the incidence of perineal hematoma.