前置胎盘患者剖宫产产后出血的高危因素调查研究

目的探讨影响前置胎盘患者剖宫产产后出血的危险因素,为减少前置胎盘患者剖宫产产后出血风险提供科学参考。方法选取2017年3月至2018年9月我院收治的240例前置胎盘剖宫产产妇为研究对象,按产后出血量分组,将产后出血量超过1000 ml的40例产妇作为观察组,产后出血量小于1000 ml的200例产妇作为对照组。采用多因素logistic回归分析前置胎盘剖宫产产妇产后出血的危险因素。结果观察组流产次数≥2次、有剖宫产史、有妊娠晚期出血、完全性前置胎盘、有胎盘粘连、有胎盘植入、胎盘附着部位为前壁者占比高于对照组(P<0.05)。多因素logistics回归分析显示,流产次数、剖宫产史、妊娠晚期出血、前置胎盘类型、胎盘粘连、胎盘植入及胎盘附着部位为影响剖宫产产后出血的独立危险因素。结论医护人员在患者妊娠期应注意排查各种危险因素,早发现、早采取相应措施预防剖宫产产后出血。

Investigation on high risk factors of postpartum hemorrhage of patients with placenta previa undergoing cesarean section

Objective To explore the risk factors influencing postpartum hemorrhage in patients with placenta previa and provide scientific reference for reducing the risk of postpartum hemorrhage in patients with placenta previa.Methods We selected 240 cases of pregnant women with placenta previa undergoing cesarean section who were treated in our hospital from March 2017 to September 2018 as the study subjects.They were grouped according to the amount of postpartum hemorrhage,40 cases of pregnant women with postpartum hemorrhage more than 1,000 ml served as the observation group,and 200 cases of pregnant women with postpartum hemorrhage less than 1,000 ml served as the control group.Multivariate logistic regression was used to analyze the risk factors of postpartum hemorrhage in patients with placenta previa undergoing cesarean section.Results The proportion of more than 2 abortions,history of cesarean section,late pregnancy bleeding,complete placenta previa,placental adhesions,placenta implantation,and placenta where the placenta was attached to the anterior wall in observation group was higher than that of the control group(P<0.05).Multivariate logistic regression analysis showed that the number of miscarriages,history of cesarean section,late pregnancy bleeding,placenta previa,placental adhesions,placenta implantation,and adherence site of placenta were independent risk factors affecting postpartum hemorrhage of cesarean section.Conclusion Medical personnel should pay attention to check out various risk factors during pregnancy.Early detection and early corresponding measures should be taken to prevention of postparturn hemorrhage.