摘要
目的产后出血是产科常见并发症。本研究旨在探讨自然分娩产妇产后出血的危险因素。方法选取2018-01-20-2019-01-20新乡同盟医院自然分娩出现产后出血的产妇作为病例组(出血组37例),未出现产后出血的产妇为对照组(91例)。统计自然分娩产妇产后出血结果及出血量,并进行自然分娩产妇产后出血的单因素分析和Logistic多因素回归分析。结果出血组出血量(623.89±36.54)mL,高于对照组的(415.63±28.52)mL,t=27.330,P<0.001。出血组年龄≥35岁(χ2=5.397,P=0.020)、体质量指数(body mass index,BMI)≥24kg/m2(χ2=11.358,P=0.001)、有流产史(χ2=15.859,P<0.001)、巨大儿(χ2=4.111,P=0.043)、凝血功能障碍(χ2=4.654,P=0.030)、胎盘异常(χ2=5.335,P=0.021)和宫缩乏力比例(χ2=5.988,P=0.014)均高于对照组。Logistic回归分析结果显示,年龄≥35岁(OR=2.214,95%CI:1.658~2.956,P=0.005)、BMI≥24kg/m2(OR=1.566,95%CI为1.236~1.985,P=0.034)、有流产史(OR=1.723,95%CI为1.369~2.168,P=0.014)、巨大儿(OR=1.846,95%CI为1.652~2.063,P=0.012)、凝血功能障碍(OR=1.648,95%CI为1.289~2.106,P=0.013)、胎盘异常(OR=1.976,95%CI为1.472~2.652,P=0.047)及宫缩乏力(OR=2.452,95%CI为2.014~2.985,P=0.036)均为自然分娩产妇产后出血的危险因素。结论自然分娩产妇易发生产后出血,危险因素包括年龄≥35岁、BMI≥24kg/m2、有流产史、巨大儿、凝血功能障碍、胎盘异常及宫缩乏力等,临床应据此制定相应预防措施,降低出血率。
OBJECTIVE Postpartum hemorrhage is a common complication of obstetrics,aiming to explore the risk factors of postpartum hemorrhage in natural delivery women.METHODS The women who had postpartum hemorrhage during the natural delivery in our hospital from January 20,2018 to January 20,2019 were selected as the case group(bleeding group),and the women who did not have postpartum hemorrhage were the control group.The results of postpartum hemorrhage and the amount of bleeding in spontaneous delivery women were counted,and the univariate analysis and logistic multivariate regression analysis of postpartum hemorrhage in natural delivery women were compared.RESULTS The bleeding volume in the bleeding group was(623.89±36.54)ml,higher than that in the control group(415.63±28.52)ml,t=27.330,P<0.001.Hemorrhage group age ≥35 years (χ~2=5.397,P=0.020),BMI≥24 kg/m^2(χ~2=11.358,P=0.001),history of miscarriage(χ~2=15.859,P<0.001),giant children(χ~2=4.111,P=0.043),coagulation dysfunction(χ~2=4.654,P=0.030),abnormal placenta(χ~2=5.335,P=0.021)and the proportion of uterine weakness(χ~2=5.988,P=0.014)were higher than the control group.Logistic regression analysis showed that age≥35 years(OR=2.214,95%CI:1.658-2.956,P=0.005),BMI≥24 kg/m^2(OR=1.566,95%CI:1.236-1.985,P=0.034),history of miscarriage(OR=1.723,95%CI:1.369-2.168,P=0.014),huge children(OR=1.846,95%CI:1.652-2.063,P=0.012),coagulopathy(OR=1.648,95%CI:1.289-2.106,P=0.013),abnormal placenta(OR=1.976,95%CI:1.472-2.652,P=0.047),hysteresis(OR=2.452,95%CI:2.014-2.985,P=0.036)were all risk factors for postpartum hemorrhage in natural labor.CONCLUSIONS Maternal spontaneous delivery is prone to postpartum hemorrhage.Age≥35 years old,BMI≥24 kg/m^2,history of miscarriage,huge child,coagulopathy,abnormal placenta,and contraction fatigue were risk factors.Therefore,clinical corresponding preventive measures should be formulated to reduce the bleeding rate.
作者
王永华
王莹
WANG Yong-hua;WANG Ying(Obstetrics and Gynecology,Xinxiang League Hospital,Xinxiang453800,P.R.China)
出处
《社区医学杂志》
2020年第19期1350-1353,共4页
Journal Of Community Medicine
关键词
自然分娩产妇
产后出血
年龄
分娩史
胎盘因素
natural delivery of women
postpartum hemorrhage
age
delivery history
placental factors
作者简介
通信作者: 王永华,女,河南新乡人,主治医师,主要从事妇产科的临床研究工作。Tel:86-373-4526925,E-mail:2951748038@qq.com。
