高龄剖宫产产妇产后出血影响因素及预防措施

Influencing factors and preventive measures of postpartum hemorrhage in elderly women with cesarean section

目的探讨高龄剖宫产产妇产后出血(PPH)影响因素及预防措施。方法144例高龄剖宫产产妇,依照PPH情况分为未出血组(产妇总出血量≤1000 ml,102例)、出血组(产妇总出血量≥1000 ml,42例)。收集并统计高龄剖宫产产妇临床资料。比较两组产后出血量及基线资料,分析高龄剖宫产产妇PPH的危险因素。结果出血组产后出血量为(1256.78±87.15)ml,多于未出血组的(608.78±45.16)ml,差异有统计学意义(t=58.554,P<0.05)。出血组妊娠期高血压、胎盘粘连、胎盘早剥、巨大儿、宫缩乏力、胎盘植入发生率均高于未出血组(P<0.05)。经logistic回归分析显示,胎盘粘连、妊娠期高血压、巨大儿、宫缩乏力均为高龄剖宫产产妇PPH的危险因素(P<0.05)。结论胎盘粘连、妊娠期高血压、巨大儿、宫缩乏力均为高龄剖宫产产妇PPH的危险因素,明确上述影响因素有助于临床实施科学合理预防措施,以降低高龄剖宫产产妇PPH率。

Objective To discuss the influencing factors and preventive measures of postpartum hemorrhage(PPH)in elderly women with cesarean section.Methods A total of 144 elderly women with cesarean section were divided into non-hemorrhage group(total blood loss≤1000 ml,102 cases)and hemorrhage group(total blood loss≥1000 ml,42 cases)according to their PPH status.The clinical data of elderly women with cesarean section was collected and counted.The amount of postpartum hemorrhage and baseline information were compared between the two groups,and the influencing factors of PPH in elderly women with cesarean section were analyzed.Results The amount of postpartum hemorrhage in the hemorrhage group was(1256.78±87.15)ml,which was more than(608.78±45.16)ml in the non-hemorrhage group,and the difference was statistically significant(t=58.554,P<0.05).The incidence of gestational hypertension,placental adhesion,placental abruption,fetal macrosomia,uterine inertia and placental implantation in the hemorrhage group were higher than those in the non-hemorrhage group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that placental adhesion,gestational hypertension,fetal macrosomia,and uterine inertia were all risk factors for PPH in elderly women with cesarean section(P<0.05).Conclusion Placental adhesion,gestational hypertension,fetal macrosomia,and uterine inertia are all risk factors for PPH in elderly women with cesarean section.Clarifying the above-mentioned influencing factors will help clinically implement scientific and reasonable preventive measures to reduce the rate of PPH in elderly women undergoing cesarean section.