Частота послеродовых кровотечений при затяжной второй стадии родов: серия клинических случаев

Relevance: Postpartum hemorrhage (PPH) remains one of the leading causes of maternal mortality worldwide, accounting for up to 27-30% of all maternal deaths. The incidence of PPH ranges from 5-10% of all deliveries, while severe forms with blood loss ≥1000 mL occur in 1-2% of women in labor. A prolonged second stage of labor is considered one of the major risk factors for uterine atony and postpartum hemorrhage, increasing its likelihood by 2-3 times. The study aimed to assess the frequency of postpartum hemorrhage in cases of prolonged second-stage labor and to determine the relationships among second-stage duration, blood loss volume, and the severity of obstetric complications. Materials and Methods: A retrospective study of 168 vaginal deliveries was conducted at the Regional Clinical Hospital and Perinatal Center №2 in Karaganda. Two groups were formed: women with a normal second stage of labor (≤60 min) and those with a prolonged second stage (>60 min). The study evaluated blood loss volume, frequency of uterine atony, use of uterotonic agents, obstetric complications, and the need for intensive care. Statistical analysis was performed using Student’s t-test, the χ² test, and odds ratio (OR); statistical significance was set at p < 0.05.