产后出血原因及危险因素分析

目的：探讨产后出血的原因及可能存在的相关危险因素。方法回顾分析2012年1月—2013年5月发生产后出血的病例59例，选取同期进行分娩未发生产后出血的118名产妇作为对照组，对比分析产后出血发生的原因及存在的高危因素。结果59例产后出血患者中子宫收缩乏力占49．2％，胎盘因素占40．7％，软产道裂伤占11．9％，凝血功能障碍占5．1％；流产史、分娩前血红蛋白＜110 g／L、产程延长、第三产程＞10 min、妊娠合并高血压、妊娠合并糖尿病、剖宫产、剖宫产史、临产后使用镇静剂以及低置胎盘，是产后出血的危险因素（ OR值分别为3．25，3．84，7．75，7．22，2．11，2．93，1．61，2．07，6.01，2．51；P＜0．05）。结论加强孕期保健、产前宣教及计划生育宣传，提高产后出血高危因素的识别和预测能力，降低剖宫产率，可以有效减少产后出血的发生。

The reasons and high-risk factors of postpartum hemorrhage

Objective To investigate the reasons and high-risk factors of postpartum hemorrhage （ PPH） .Methods A retrospective study of matched-control was performed that focused on the period of January 2012 to May 2013.A total of fifty nine pregnant women with PPH were identified and matched to 118 pregnant women without PPH.Results The cases of postpartum hemorrhage suffered uterine atony （49.2%） , placenta accrete （40.7%） ,soft birth canal laceration （11.9%） and blood coagulation dysfunction （5.1%） at the same time.The followings were risky factors causing PPH： previous abortion history, HGB 〈110 g/L, prolonged labor, third stage longer than 10 min, pregnancy induced hypertension or diabetes, cesarean, history of cesarean and low-lying placenta （ OR =3.25,3.84,7.75,7.22,2.11,2.93,1.61,2.07,6.01,2.51, respectively;P〈0.05）.Conclusions In order to reduce the incidence rate of postpartum hemorrhage, the clinic should pay more attention on antenatal care, prenatal education and family planning publicity, and improve the ability of recognition and prediction for high-risk factors of postpartum hemorrhage.