产前出血原因及其对妊娠结局的影响

Analysis of causes of antenatal hemorrhage and its effects on pregnancy outcome

目的探讨产前出血的原因、处置方法及其对妊娠结局的影响。方法本研究产妇分为三组：W组（未出血组）、S组（少量出血组）和D组（大量出血组），并对其年龄、孕产次、出血原因、妊娠合并症及妊娠结局进行分析。结果s组产后出血发生率、子宫切除发生率、产褥感染率、贫血发生率均明显高于w组，D组产后出血发生率、子宫切除发生率，贫血发生率均明显高于s组；S组早产发生率明显高于w组，D组胎儿窘迫发生率、早产发生率、新生儿窒息发生率、死亡发生率均明显高于s组。结论胎盘因素和宫颈因素是导致产前出血的主要原因，大量出血时母儿不良妊娠结局发生率较高，少量出血期待治疗可改善新生儿结局。

Objective To investigate the causes of antenatal hemorrhage, treatment methods and their effects on pregnancy outcome. Methods Puerperants in the study were divided into three groups： group W （non -bleeding group）, group S （small bleeding group） and group D （bleeding group ）. The age, gravidity, cause of hemorrhage, pregnancy complications and pregnancy outcomes were analyzed. Results The incidence of postpartum hemorrhage, the incidence of hysterectomy, puerperal infection rate and the incidence of anaemia in group S were significantly higher than those in group W. The incidence of postpartum hemorrhage, hysterectomy and anaemia in group D were significantly higher than those in group S. The incidence of preterm birth in group S was higher than that in group W; The inci- dence of fetal distress, premature delivery, neonatal asphyxia and mortality in group D were significantly higher than those in group S. Conclusions Placenta and cervix factors are the major causes of antenatal haemon-hage. When there are massive bleeding in antenatal haemorrhage, the incidence of maternal and neonatal adverse pregnancy outcomes are higher. Less bleeding expectant treatment can improve the neonatal survival rate.