摘要
目的:分析剖宫产产后出血的产前高危因素,为预防产后出血提供依据。方法:将暨南大学附属第一医院2002年1月～2008年12月间住院行剖宫产术终止妊娠发生产后出血的产妇100例作为病例组,选择同期非出血剖宫产产妇100例作为对照组。采用回顾性病例对照研究设计方法,对比两组产后出血相关危险因素的暴露率及结局。结果:高龄、孕次≥3次、经产妇、流产≥2次、文化程度低、妊娠期高血压疾病、中重度贫血、红细胞<3.50×109/L、妊娠合并子宫肌瘤(≥3cm)、前置胎盘、血小板<100×109/L、胎盘早剥、宫缩抑制剂的使用、多胎均为产后出血的高危因素。经多因素Logistic回归分析,产前应用宫缩抑制剂、经产妇、妊娠合并子宫肌瘤(≥3 cm)、前置胎盘、双胎和文化程度低是剖宫产产后出血的独立高危因素。结论:产前使用宫缩抑制剂者应加强产后出血的防治,妊娠合并子宫肌瘤直径≥3 cm者,不建议在剖宫产术中常规实施子宫肌瘤剔除术。
Objective： To analyze the prenatal high risk factors of postpartum hemorrhage after cesarean section, and provide a basis for prevention of postpartum hemorrhage. Methods： Among the resident patients cases from January 2002 to December 2008, 100 women with postpartum hemorrhage resulting from termination of pregnancy with cesarean section were selected as study group, 100 women without postpartum hemorrhage after cesarean section were selected as control group. The exposure rate of related high risk factors of postpartum hemorrhage and outcomes in the two groups were compared by retrospective case - control study. Results： The high risk factors of postpartum hemorrhage included advanced age, gravidity≥3, multipara, frequency of abortion≥2, low level of education, hypertensive disorder complicating pregnancy, moderate and severe anemia, red blood cell 〈 3.50 × 10^9/L, uterine leiomyoma （ diameter ≥ 3 cm ）, placenta previa, platelet 〈 100 × 10^9/L, placental abruption, use of inhibitors of uterine contraction and polyembryony. Multiple factors logistic regression a- nalysis showed that the independent high risk factors of postpartum hemorrhage included prenatal use of inhibitors of uterine contraction, multipara, pregnancy complicated by uterine leiomyoma （diameter ≥ 3 cm ）, placenta previa, twin pregnancy and low level of education. Conclusion： Prevention and treatment of postpartum hemorrhage should be strengthened in pregnant women with prenatal use of inhibitors of uterine contraction, for the pregnant women with uterine leiomyoma （diameter≥3 cm）, uterine myomectomy is not recommended during cesarean section.
出处
《中国妇幼保健》
CAS
北大核心
2010年第6期749-751,共3页
Maternal and Child Health Care of China
关键词
剖宫产
产后出血
产前因素
预防
Cesarean section
Postpartum hemorrhage
Prenatal factors
Prevention
