病理性引产因素对中期妊娠引产并发症的影响

Effects of pathological factors on complications of induced labor in second-trimester pregnancy

目的探讨病理性引产因素对中期妊娠引产并发症的影响。方法收集1367例因病理性因素实施中期妊娠引产患者的临床资料,收集导致其中期引产的病理因素,进一步分析病理因素对中期妊娠引产并发症(并发胎盘残留、感染及PPH)的影响。结果1367例患者中行中期妊娠引产的病理因素主要为胎盘前置(26.85%,367/1367)、死胎(22.75%,311/1367)、高风险瘢痕子宫(17.92%,245/1367);患者出现的主要引产并发症为(37.16%,508/1367)、感染(17.34%,237/1367)、产后出血(PPH)(5.41%,74/1367)。胎盘前置状态(OR=5.371)、胎盘植入(OR=4.019)、瘢痕子宫(OR=3.255)及死胎(OR=3.222)为胎盘残留的危险因素;宫颈机能不全(OR=5.043)、胎盘前置(OR=2.422)、未足月胎膜早破(PPROM)(OR=2.702)及死胎(OR=2.544)为感染的危险因素;胎盘早剥(OR=12.386)、胎盘植入(OR=8.585)、瘢痕子宫(OR=4.008)及胎盘前置状态(OR=3.353)为PPH的危险因素。结论因胎盘前置状态、胎盘植入、高风险瘢痕子宫及死胎行中期妊娠引产孕妇应注意胎盘残留的可能性,因宫颈机能不全、胎盘前置、PPROM及死胎行中期妊娠引产孕妇应注意感染可能,因胎盘早剥、胎盘植入、高风险瘢痕子宫及胎盘前置状态引产孕产妇应注意PPH可能。

Objective To investigate the effects of pathological factors on the complications of induced labor in the second-trimester pregnancy.Methods We retrospectively analyzed the clinical data from 1367 cases of patients with induced labor in second-trimester pregnancy due to pathological factors,and collected the pathological factors,and further analyzed the effects of pathological factors on the complications of induced labor in the second-trimester pregnancy[complicated with placental residue,infection and postpartum hemorrhage(PPH)].Results The main pathological factors among the 1367 cases were placenta previa(26.85%,367/1367),stillbirth(22.75%,311/1367),and high-risk scar uterus(17.92%,245/1367).The main complications were placental residuals(37.16%,508/1367),infection(17.34%,237/1367),and PPH(5.41%,74/1367).Placenta previa(OR=5.371),placenta accreta(OR=4.019),high-risk scar uterus(OR=3.255)and stillbirth(OR=3.222)were the risk factors of placental residues.Incompetence cervical(OR=5.043),placenta previa(OR=2.422),preterm premature rupture of membranes(PPROM)(OR=2.702),and stillbirth(OR=2.544)were the risk factors for infection.Placental abruption(OR=12.386),placenta accreta(OR=8.585),high risk scar uterus(OR=4.008)and placenta previa(OR=3.353)were the risk factors for PPH.Conclusion Pregnant women whose labor was induced due to placenta previa,placenta accreta,high-risk scar uterus and stillbirth should pay attention to the possibility of placenta residue,those whose labor was induced due to incompetence cervical,placenta previa,PPROM and stillbirth should pay attention to infection,and those whose labor was induced due to placental abruption,placenta accreta,high-risk scar uterus and placenta previa should pay attention to PPH.