产后胚物残留合并子宫动静脉瘘发病的危险因素分析

目的:探讨产后胚物残留合并子宫动静脉瘘发生的危险因素。方法:选取河北省唐山市妇幼保健院2000年1月至2020年12月近20年内产后胚物残留合并子宫动静脉瘘患者26例作为病例组；选取同时段产后胚物残留未并发子宫动静脉瘘患者32例作为对照组，病例组及对照组均为剖宫产瘢痕部位胚物残留。通过单因素及多因素Logistic分析...

Analysis of risk factors of fetal residue after delivery combined with uterine arteriovenous fistula

Objective To investigate the risk factors of postpartum embryo residues associated with uterine arteriovenous fistula. Methods From January 2000 to December 2020,26 cases of postpartum embryo residue complicated with uterine arteriovenous fistula in Tangshan Maternal and Child Health Hospital were selected as the case group, and 32 cases of postpartum embryo residue without uterine arteriovenous fistula were selected as control group. Both the case group and the control group had embryo residue in cesarean scar. Univariate and multivariate logistic analysis were used to screen the risk factors of postpartum embryo residue combined with uterine arteriovenous fistula. Results There were 26 patients in the case group,including 3 patients after medical abortion,17 patients after artificial abortion,2 patients after cesarean section, and 4 patients after mid-term induced labor. There were 32 patients in the control group, including 7 patients after medical abortion, 11 patients after induced abortion, 8 patients after cesarean section, and 6 patients after mid-term induced labor. There were 11 patients in the case group and 3 patients in the control group. Univariate analysis showed that:the occurrence of postpartum embryo residue combined with uterine arteriovenous fistula was related to the time of vaginal bleeding, HCG value before and after treatment, hemoglobin value before treatment, platelet count and residual embryo area (all P < 0. 05). Multivariate regression analysis showed that the increase of hCG before treatment (OR 20. 319,95%Cl 1. 348 -306. 187) and the decrease of hemoglobin before treatment (OR 0. 870,95%Cl 0. 788-0. 960) were the independent risk factors of postpartum embryo residue combined with uterine arteriovenous fistula (all P<0.05). Conclusion The risk factors of uterine arteriovenous fistula in postpartum embryo residue patients with elevated hCG value and decreased hemoglobin value before treatment should be highly vigilant to reduce the rate of clinical missed diagnosis. © 2021, Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.