359例產後出血的臨床分析

Clinical analysis of 359 cases of postpartum hemorrhage

目的探討產後出血的原因、高危因素及產後出血與分娩方式的關係。方法回顧分析本院自2016年1月~2018年12月分娩的產婦的出血量,對陰道分娩與剖宮產後出血病例作比較及原因分析。結果產後出血的病例共359例,產後出血發生率為3.51%。產後出血的原因以宮縮乏力為主,共有260例,佔70.75%。最常見的高危因素是高齡,佔16.42%。產後出血≥500ML,有276例,佔76.88%;產後出血≥1000ML,有68例,佔18.94%;產後出血≥2000ML,有15例,佔4.18%。產後出血以陰道產為主,有統計學意義(P<0.05)。結論合理使用宮縮藥物,減少宮縮乏力的發生;對高齡孕婦加強孕期管理及分娩期的監護,以減少產後出血的發生。

Objective To evaluate the causes of postpartum hemorrhage(PPH),high risk factors and the relationship with delivery methods.Methods Retrospective analysis of the cases in which blood lost≥500ml after vaginal birth or≥1000ml after cesarean deliveries from January 2016 to December 2018 in Kiang Wu Hospital.Results 359 cases of postpartum hemorrhage were reviewed.The incidence of postpartum hemorrhage was 3.51%(359/10223).The major cause for postpartum hemorrhage was uterine atony,taking up 70.75%(254/359).The most common risk factor of postpartum hemorrhage was advanced maternal age.Among all PPH,the incidence of minor,moderate and severe PPH was 76.88%,18.94%and 4.18%respectively.There were more PPH after vaginal birth than after cesarean deliveries(P>0.05).Conclusion Preventions of uterus atony,management of high-risk pregnancy,close monitoring during labor and use of uterotonic drugs could reduce the occurrence of PPH.