摘要
目的 分析产后出血发生的相关危险因素 ,探讨预防和减少产后出血的措施。方法 对我院1 990年 1月～ 2 0 0 2年 1 2月间住院分娩的产妇出现产后出血的产妇 31 9例 ,对照 6 38例。通过多元Logistic回归分析评价各危险因素的相对危险性。结果 产后出血的发病率为 2 0 9%。相对独立的多个危险因素作用大小的顺位为 :胎盘粘连或植入、前置胎盘、多胎妊娠及胎儿体重≥ 4 0 0 0g、重度妊高征、流产次数≥ 2次、胎盘早剥 ;在阴道分娩的产妇中 ,作用相对独立的危险因素的顺位为胎盘粘连或植入、胎儿体重≥ 4 0 0 0g、妊高征、第三产程 >1 0min、流产次数≥ 2次。结论 避免产前非意愿妊娠以减少前置胎盘、胎盘粘连或植入 ;减少巨大儿、多胎的发生 。
Objective To investigate high risky factors causing postpartum hemorrhage (PPH). Methods A retrospective study of matched case-control was performed among 15,238 deliveries in Peking University Third Hospital between January 1990 to December 2002.A total of 319 pregnant women with PPH were identified and matched to 638 pregnant women without PPH.Multivariate regression was performed for the statistical analysis. Results PPH occurred in 310 of the 15,238 deliveries,with an incidence of 2 09%.The following are risky factors causing PPH in the order: placenta accreta or increta,placenta previa,big birth (weight≥4 000 g),severe pregnancy induced hypertension,having more than twice of previous abortion history,placental abruption. The sequence of increased risk at PPH in women who succeed in vaginal delivery were: placenta accreta or placenta increta,big birth (weight≥4 000 g),pregnancy induced hypertension,third stage longer than 10 minutes,having more than twice of previous abortion history. Conclusions Controlling fetal weight and avoiding previous abortion can minimize the risky factors of placenta previa and placenta accreta or increta,and thus produce the incidence of PPH.
出处
《中国妇产科临床杂志》
2003年第4期266-268,256,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
关键词
产后出血
胎盘
流产
postpartum hemorrhage
placenta
abortion
