胎盘早剥程度及母儿预后的临床危险因素  

Clinical risk factors of severity of placental abruption and maternal and infant outcomes

作　　者：刘久英[1] 王琳[2] 蔡晓楠[3] 杨意 宋晓婕[1] 

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院),湖北武汉430016 [2]广西壮族自治区人民医院妇产科,广西南宁530021 [3]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)中心实验室,湖北武汉430016

出　　处：《中国妇幼保健》2018年第5期1000-1002,共3页Maternal and Child Health Care of China

基　　金：2016年湖北省卫生和计划生育委员会科研项目立项课题(WJ2017F041)

摘　　要：目的探讨胎盘早剥程度以及母儿预后的相关临床危险因素,以期改善母儿结局。方法收集2007年1月-2012年12月在该院住院确诊的167例胎盘早剥孕妇的临床资料,采用Logistic回归方法对年龄、产次、外伤、脐带情况、是否催产等影响胎盘早剥程度及母儿预后的高危因素进行单因素和多因素分析。结果 167例胎盘早剥孕妇中,胎盘早剥Ⅰ度91例(轻型组),Ⅱ度38例(中型组),Ⅲ度38例(重型组);单因素回归分析显示,重型组孕妇产次、产时出血量、输血量、子宫胎盘卒中率、新生儿窒息、死胎率与中、轻型组比较,差异有统计学意义(P<0.05)。多因素分析显示,产次、子宫胎盘卒中、休克及死胎是胎盘早剥的独立高危因素(P<0.05)。结论重视发生胎盘早剥的经产妇、休克及死胎孕妇,警惕重度胎盘早剥的发生。Objective To explore the relevant clinical risk factors of severity of placental abruption and maternal and infant outcomes, improve maternal and infant outcomes. Methods The clinical data of 167 pregnant women diagnsoed as placental abruption definitely in the hospital from January 2007 to December 2012 was collected. Univariate and multivariate logistic regression models were used to analyze the high-risk factors （age, parity, trauma, umbilical cord, labor） of severity of placental abruption and maternal and infant outcomes. Results There were 91 cases of I degree placental abruption （ mild group） , 38 cases of Ⅱ degree placental abruption （ moderate group） , and 38 cases of Ⅲ degree placental abruption （ severe group） . Univariate regression analysis showed thai there were statistically significant differences in parity, amount of intrpartum hemorrhage, blood transfusion volume, incidence rates of uteroplaeental apoplexy, neonatal as- phyxia, and stillbirth between severe group and mild group, moderate group （P〈 0. 05 ） . Multivariate regression analysis showed that pari- ty, uteroplacental apoplexy, shock, and stillbirth were independent high-risk factors of placental abruption （P〈0. 05） . Conclusion More attention should be paid to the muhiparous women with placental abruption, shock, and stillbirth to prevent the occurrence of severe placental abruption.

关 键 词：重度胎盘早剥 危险因素 经产妇 死胎 

分 类 号：R714.2[医药卫生—妇产科学]