低危妊娠阴道分娩发生产后出血的危险因素分析  

Analysis of Risk Factors for Postpartum Hemorrhage during Vaginal Delivery in Low Risk Pregnancy

作　　者：杨丽娜[1] 耿力[1] YANG Li-Na;GENG Li(Dept.of Obstetrics,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院产科,云南昆明650032

出　　处：《昆明医科大学学报》2020年第9期62-66,共5页Journal of Kunming Medical University

基　　金：昆明医科大学第一附属医院博士启动基金资助项目(2013BS06)。

摘　　要：目的研究无妊娠并发症、合并症及子宫手术史的单胎妊娠阴道分娩发生产后出血的危险因素。方法回顾性分析2019年7月至2019年12月在昆明医科大学第一附属医院阴道分娩的无妊娠并发症、合并症及子宫手术史的单胎妊娠阴道分娩的181例。根据是否发生产后出血,分为产后出血组(81例)及非产后出血组(100例)。对产后出血组产妇及非产后出血组产妇的年龄、孕次、产次、血型、孕期体重增长、是否人工破膜、第一产程、第二产程及第三产程的时间、是否侧切、是否人工剥离胎盘、新生儿体重、新生儿性别进行单因素分析及Logistic回归分析。结果在单因素分析中会阴侧切、第二产程≥2 h及第三产程大于≥30 min对产后出血的影响,差异有统计学意义(P<0.05)。Logistic回归分析显示孕期体重增长过多、第三产程大于≥30 min及会阴侧切是产后出血的独立危险因素(P<0.05)。结论对于无妊娠并发症及合并症的低危妊娠阴道分娩的产妇来说,孕期体重的管理、产程管理及降低会阴侧切率对减少产后出血的发生都尤为重要。Objective To study the risk factors of postpartum hemorrhage during the vaginal delivery of single pregnancy without complications of pregnancy and history of uterine surgery.Methods 181 cases of single pregnancy and vaginal delivery with no history of uterine surgery complications and pregnancy complications were retrospectively analyzed from July 2019 to December 2019 in the First Affiliated Hospital of Kunming Medical University.According to the occurrence of postpartum hemorrhage,they were divided into the postpartum hemorrhage group(81 cases)and the non-postpartum hemorrhage group(100 cases).Univariate analysis and Logistic regression analysis were carried out to investigate whether postpartum hemorrhage group or non-postpartum hemorrhage group experienced gestational weight gain in terms of age,pregnancy,first stage of labor,second stage of labor,and third stage of labor,lateral incision,artificial dissection of the placenta,neonatal weight,and neonatal sex.Result In the univariate analysis,the second stage of perineal lateral incision≥2 hours and the third stage≥30 minutes had significant effects on postpartum hemorrhage(P<0.05).Logistic regression analysis showed that excessive weight gain during the pregnancy,the third stage of labor greater than 30 minutes,and the lateral perineum were the independent risk factors for postpartum hemorrhage(P<0.05).Conclusion For the parturient of vaginal delivery of low risk pregnancy without pregnancy complications and complications,the management of pregnancy weight during the gestational period,management of labor period and the reduction of perineal incision rate may be particularly important to reduce the occurrence of postpartum hemorrhage.

关 键 词：产后出血 危险因素 阴道分娩 回顾性研究 

分 类 号：R714.46[医药卫生—妇产科学]