妊娠晚期出血132例原因分析

Reason analysis of late pregnancy bleeding in 132 cases

目的探讨分析桑给巴尔奔巴岛地区妊娠晚期出血发生率及其原因,以提高产科质量。方法回顾性分析2009年6月至2012年5月奔巴岛Abdulla Mzee医院分娩的132例妊娠晚期大出血患者的临床资料。结果奔巴岛Abdulla Mzee医院2009年6月至2012年5月收治妊娠晚期大出血患者132例,占同期分娩总数的2.54%(132/5 207),132例患者中胎盘早剥77例(58.33%),妊娠高血压疾病、胎膜早破、创伤为引起胎盘早剥的主要原因;前置胎盘38例(28.79%);子宫破裂13例(9.85%);胎盘前置血管破裂4例(3.03%)。围生儿死亡和死胎29例。结论妊娠晚期出血严重威胁母婴生命,如处理不及时,妊娠结局差。在桑给巴尔这种医疗条件比较落后的地区,预防的意义更加重大。当地医护人员应提高医疗技术水平,建立并完善正规的产前检查系统,以提高产科质量,减少妊娠晚期出血发生率。

Objective To explore and analyze the incidence rate and reasons of late pregnancy bleeding for improving the obstetric quality in the Pemba island area of Zanzibar.Methods The retrospective analysis was employed on the clinical data in 132 patients with late pregnancy bleeding in Abdulla Mzee Hospital on Pemba island from June 2009 to May 2012.Results 132 cases of late pregnancy massive bleeding treated in this hospital during this period accounted for 2.54%（132/5 207） of con temporaneous total deliveries.Among them,77 cases（58.33%） were placental abruption;gestational hypertensive disorders,premature rupture of fetal membranes and trauma were the main causes leading to placental abruption;38 cases（28.79%） were placenta previa;13 cases（9.85%） were rupture of the uterus;4 cases（3.03%） were rupture of placenta previa vasa;perinatal death and dead fetus were 29 cases.Conclusion Late pregnancy bleeding threats critically the lives of mothers and neonates,if without immediate treatment,the pregnancy outcome will be poor.The significance of prevention is very significant in this area with backward medical conditions in Zanzibar.The local medical staff should increase the medical technical level,establish and perfect the normal antenatal examination system to improve the obstetric quality and reduce the incidence rate of late pregnancy bleeding.