阴道分娩产后出血的危险因素分析

Analysis of the Risk Factors of Vaginal Delivery Postpartum Hemorrhage

目的探讨引起阴道分娩产后出血的危险因素,并提出相应的预防措施。方法采用1∶1配对病例对照研究方法,对可能引起阴道分娩产后出血的危险因素进行单因素分析和多因素条件Logistic回归分析。结果病例组产妇子宫收缩乏力、胎盘因素(胎盘残留/粘连/植入)、软产道损伤、妊娠期高血压、胎儿体重≥4000g的比例均高于对照组(P均<0.05);多因素条件Logistic回归分析显示,引起阴道分娩产后出血的危险因素有子宫收缩乏力、胎盘因素(胎盘残留/粘连/植入)和妊娠高血压。结论阴道分娩产后出血受多种因素的影响,应根据不同的危险因素采取不同的措施对症治疗,积极预防产后出血的发生,改善产妇预后。

Objective To investigate the risk factors and preventive measures of postpartum hemorrhage after vaginal delivery.Methods A 1∶1 matched case-control study was conducted to compare univariate and multivariate conditional logistic regression analysis of risk factors for postpartum hemorrhage in vaginal delivery.Results The proportion of uterine contraction,placental factors(placental residue/adhesion/implantation),soft birth canal injury,hypertensive disorders in pregnancy,fetal weight≥4000g of the case group were significantly higher than those of the control group(P<0.05).The Multi-factor conditional logistic regression analysis suggested that the uterine contraction,placental factors(placental residue/adhesion/implantation)and hypertensive disorders in pregnancy were all risk for vaginal delivery postpartum hemorrhage.Conclusion Postpartum hemorrhage in vaginal delivery is affected by many risk factors.In clinical practice,we should put forward different measures for various risk factors to prevent the occurrence of postpartum hemorrhage,to improve maternal outcomes.