高龄孕妇剖宫产产后出血危险因素分析

Analysis of the risk factors of the postpartum hemorrhage in advanced age pregnant women

目的探讨高龄孕妇剖宫产产后出血的主要危险因素。方法回顾性分析2010年1月至2011年6月期间在北京民航总医院剖宫产分娩的623例高龄孕妇(年龄≥35岁)的临床资料,分为产后出血组(胎儿娩出后2h内出血量≥400ml或至胎儿娩出后24h内出血量≥500ml)和非产后出血组,对可能影响术后出血的因素进行单因素分析与Logistic回归分析。结果 623例高龄孕妇剖宫产产后出血52例,发生率为8.35%。单因素分析有妊娠高血压疾病、妊娠期糖尿病、流产病史、经产妇、巨大儿、宫缩乏力和前置胎盘7种指标与高龄孕妇产后出血相关。非条件多因素分析结果筛选出3个主要的危险因素:宫缩乏力、前置胎盘、妊娠高血压疾病。结论高龄孕妇剖宫产产后出血的发生率较高。宫缩乏力、前置胎盘、妊娠高血压疾病是高龄孕妇剖宫产发生产后出血的主要危险因素。

Objective To analyze the risk factors of the postpartum hemorrhage of advanced age pregnant women.Methods Data of 623 cases of advanced age pregnant women who delivered in our department from January 2010 to June 2011 were analyzed retrospectively. They were divided into postpartum hemorrhage group and no postpartum hemorrhage group according to if they had postpartum hemorrhage. Risk factors that may affect postpartum hemorrhage were determined by Logistic regression analysis.Results Seven factors associated with postpartum hemorrhage. The main risk factors were uterine inertia, placenta praevia and gestational hypertension. Conclusions There is a higher incidence of postpartum hemorrhage in advanced age pregnant women. Uterine inertia, placenta praevia and gestational hypertension are the main risk factors of postpartum hemorrhage in the advanced age pregnant women.