影响高龄孕妇剖宫产发生产后出血的危险因素探讨

Study on risk factors of postpartum hemorrhage among pregnant women in elder age after cesarean section

目的:探讨影响高龄孕妇剖宫产发生产后出血的危险因素。方法:选择40例剖宫产产后出血的高龄孕妇为研究组,同期行剖宫产产后非出血的高龄孕妇460例为对照组。对可能造成术后出血的因素进行单因素分析,对于影响显著的因素进行多因素Logistic回归分析。结果:研究组中的妊娠高血压史、流产史、宫缩乏力、巨大儿及前置胎盘的发生率明显高于对照组(P<0.05)。经多因素Logistic回归分析,高龄孕妇剖宫产发生产后出血的高危因素依次为宫缩乏力、前置胎盘、妊娠高血压史、巨大儿、流产史。结论:影响高龄孕妇剖宫产发生产后出血的主要因素为宫缩乏力、前置胎盘、妊娠高血压史,为临床有效预防高龄孕妇剖宫产产后出血提供了理论依据。

Objective：To explore the risk factors of postpartum hemorrhage among pregnant women in elder age after cesarean section. Methods： Forty pregnant women in elder age with postpartum hemorrhage after cesarean section were selected as study group, and 460 pregnant women in elder age without postpartum hemorrhage after cesarean section during the same period were selected as control group. The factors which might induce postoperative hemorrhage were analyzed by univariate analysis, then the significant factors were analyzed by multi- variate logistic regression analysis. Results：The incidence rates of medical history of hypertensive disorder complicating pregnancy （HDCP）, history of abortion, uterine inertia, macrosomia, and placenta previa in study group were statistically significantly higher than those in control group （P 〈 0. 05 ）. The results of multivariate logistic regression analysis showed that the high risk factors of postpartum hemorrhage among pregnant women in elder age included uterine inertia, placenta previa, medical history of HDCP, macrosomia, and history of abortion succes- sively. Conclusion： The main influencing factors of postpartum hemorrhage among pregnant women in elder age include uterine inertia, placenta previa, and medical history of HDCP, which provide a theoretical basis for effective prevention of postpartum hemorrhage among pregnant women in elder age in clinic.