剖宫产术后晚期产后出血相关因素分析

目的探讨剖宫产术后晚期产后出血时间、病因、防治措施。方法对2003年6月至2008年6月本院收治的47例剖宫产术后晚期产后出血病例进行回顾性分析。结果发病原因依次为：子宫切口感染，子宫切口裂开，胎盘、蜕膜残留，子宫复旧不良。病例剖宫产指征多见于：产程异常、头盆不称、胎儿窘迫、妊高征、前置胎盘、剖宫产史等。发生时间以剖宫产术后〉3周者占多数（65．96％），其中部分病例（12．77％）〉6周。结论剖宫产术后晚期产后出血的时间不应局限于产褥期内，其主要病因是子宫切口感染、裂开，多见于产程异常所行剖宫产。对病因的诊断、防治值得重视。

Objective To explore the time, etiological factors, treatments for prevention and cure of late postpartum hemorrhage after caesarean section. Methods Retrospective analysis was undertaken to 47 cases of late postpartum hemorrhage ater caesarean section collected from the hospital between 2003,6 and 2008,6. Results The causes were infection of incisional wound, disruption of wound, residual of placenta and decidua, poor involution of uterus in turn. The indication of caesarean section were labor abnormality, cephalopelvic disproportion, fetal distress, gestational hypertension, placental presentation, uterine - incision delivery history and so on. Mostly happened 3 weeks later after caesarean section（65.96% ）, part of them（ 12. 77% ） happened 6 weeks later. Conclusions The late postpartum hemorrhage is not confined to puerperium only after caesarean section. The major causes are of ineisional wound infection and disruption of wound, which mainly oceurrs in uterine - incision delivery after labor abnormality. The etiopathogenisis is of importance for better diagnosis, prevention and treatment of such disease.