前置胎盘剖宫产产后出血情况和影响因素及应对措施分析

Analysis of Postpartum Hemorrhage and Influencing Factors in Placenta Previa Cesarean Section and Countermeasures

目的探讨前置胎盘剖宫产产后出血影响因素。方法选取临颍县妇幼保健院2019年10月至2023年10月行剖宫产的100例前置胎盘产妇,分析产妇的临床资料,采用容积法和称重法统计产后出血量。观察产妇产后出血发生情况并采用单因素和多因素分析影响因素。结果100例前置胎盘产妇发生产后出血31例,发生率为31.00%。产后出血组与非产后出血组流产次数、剖宫产次数、胎盘粘连、宫缩乏力、产前血红蛋白差异有统计学意义(P<0.05)。Logistic回归分析结果显示,流产次数(OR=3.554,95%CI:3.086~4.054)、剖宫产次数(OR=3.080,95%CI:2.680~3.491)、胎盘粘连(OR=3.242,95%CI:2.758~3.744)、宫缩乏力(OR=1.394,95%CI:1.293~1.501)、产前血红蛋白(OR=1.910,95%CI:1.645~2.180)均是前置胎盘剖宫产产后出血的独立危险因素(P<0.05)。结论临颍县妇幼保健院4年内100例前置胎盘产妇剖宫产产后出血发生率为31.00%,流产次数、剖宫产次数、胎盘粘连、宫缩乏力、产前血红蛋白均为产后出血影响因素,应加强影响因素的重点预防,结合有效措施降低产后出血发生率。

Objective To explore the influencing factors of postpartum hemorrhage in placenta previa cesarean section.Methods 100 cases of placenta previa women who underwent cesarean section from October 2019 to October 2023 in Linying County Maternal and Child Health Hospital were selected.The clinical data of the women were analyzed,and the volume method and weighing method were used to count the amount of postpartum hemorrhage.The occurrence of postpartum hemorrhage in women was observed and the influencing factors were analyzed by univariate and multivariate analysis.Results 31 out of 100 cases of placenta previa women had postpartum hemorrhage,with an incidence rate of 31.00%.There were statistically significant differences in the number of abortions,the number of cesarean sections,placental adhesion,uterine atony,and preoperative hemoglobin between the postpartum hemorrhage group and the non-postpartum hemorrhage group(P<0.05).Logistic regression analysis showed that the number of abortions(OR=3.554,95%CI:3.086~4.054),the number of cesarean sections(OR=3.080,95%CI:2.680~3.491),placental adhesion(OR=3.242,95%CI:2.758~3.744),uterine atony(OR=1.394,95%CI:1.293~1.501),and preoperative hemoglobin(OR=1.910,95%CI:1.645~2.180)were all independent risk factors for postpartum hemorrhage in placenta previa cesarean section(P<0.05).Conclusion The incidence of postpartum hemorrhage in 100 cases of placenta previa women who underwent cesarean section in Linying County Maternal and Child Health Hospital in the past four years was 31.00%.The number of abortions,the number of cesarean sections,placental adhesion,uterine atony,and preoperative hemoglobin are all influencing factors of postpartum hemorrhage.It is necessary to strengthen the key prevention of influencing factors and combine effective measures to reduce the incidence of postpartum hemorrhage.