瘢痕子宫患者再次妊娠剖宫产产后出血的相关因素分析

Analysis the related factors of postpartum hemorrhage in patients of cesarean section uterine scar with Subsequent Pregnancy

目的观察总结导致瘢痕子宫患者再次妊娠剖宫产产后出血的相关因素。方法选取2012年1月-2013年12月我院产科收治的已经确诊为瘢痕子宫并再次妊娠行剖宫产术的产妇130例,设为观察组;另选取同时期于我院产科就诊的130名进行剖宫产术的初产妇,设为对照组。比较两组产妇剖宫产后出血例数、平均每例的出血量和并发症发生率,并分析观察组产妇剖宫产术后出血的相关因素以及手术时间与产后出血量的关系。结果观察组产妇剖宫产后出血例数和平均出血量明显高于对照组（P〈0.05）。观察组瘢痕子宫的产妇行剖宫产后出现并发症的概率明显高于对照组（P〈0.05）。胎盘粘连、前置胎盘、子宫破裂和胎盘植入主要危险因素。观察组瘢痕子宫的产妇进行剖宫产后出血量和剖宫产手术时间呈递增的关系。结论我们应当重视引起产后出血的相关因素,采取积极的预防和治疗措施,以达到减少产妇剖宫产产后出血的发生的目的,最大程度的保障产妇的生命安全。

Objective To observe and summarize the related factors of postpartum hemorrhage in patients of cesarean section uterine scar with subsequent pregnancy. Methods 130 puerperant of cesarean section uterine scar with subsequent pregnancy were selected to be observation group in our hospital from January 2012 to December 2013, while 130 cesarean section primipara were selected to be control group. To compare the numbers of postpartum hemorrhage of cesarean section, the average blood loss of each case and the incidence of complications between the two group. To analyze the relationship between the related factors in hemorrhage after cesarean section, the cesarean section operation time and the amount of postpartum hemorrhage in observation group. Results The numbers of postpartum hemorrhage of cesarean section and the average blood loss of each case were significantly higher compared with control group（P〈0.05）. The incidence of complications in observation group were significantly higher than control group（P〈0.05）. The main risk factors were adherent placenta, placenta previa, uterine rupture and placenta increta. The amount of hemorrhage after cesarean section was increasing along with the cesarean section operation time. Conclusion The related factors of postpartum hemorrhage should be pay attention to take positive measures for the prevention and treatment, in order to reduce the incidence of postpartum hemorrhage of cesarean section and to greatly guarantee the life safety of puerperant.