Evaluation of risk factors of puerperal genital hematomas in women after vaginal delivery

ObjectiveTo assess the risk factors of puerperal genital hematomas in women after vaginal delivery. Methods Clinical data of 34 945 cases of vaginal delivery were reviewed retrospectively. According to the incidence of puerperal genital hematomas, 112 women presenting with puerperal genital hematomas were divided into the genital hematomas group, and 260 randomly selected from 34 833 normal women were assigned into the control group. Clinical data of 372 cases were collected and compared between two groups. The risk factors of puerperal genital hematomas were assessed by logistic regression analysis. Results The total incidence of puerperal genital hematomas was 0.32% （112/34 945） in this study. No statistical significance was observed in the gravidity, first stage of labor time, second stage of labor time, the number of precipitate labor, neonatal birth weight and the number of macrosomia between two groups （all P > 0.05）. However, the proportion of nulliparity, episiotomy, perineal laceration, vaginal laceration, and instrumental delivery in the genital hematomas group was significantly higher compared with that in the control group （all P < 0.05）. Multivariate logistic regression analysis showed that nulliparity （OR=1.663, 95%CI 1.003-2.757） and vaginal laceration （OR=3.698, 95%CI 1.962-6.970） were risk factors of puerperal genital hematomas （both P < 0.05）. Conclusions Nulliparity, episiotomy, perineal laceration, vaginal laceration, and instrumental delivery are associated with a higher rate of puerperal genital hematomas. Clinicians should pay extensive attention to nulliparity and vaginal laceration, deliver effective interventions and improve clinical prognosis of pregnant women after vaginal delivery.