足月妊娠期高血压及非重度子痫前期孕妇引产后严重产后出血的危险因素分析  

Risk Factors for Severe Postpartum Hemorrhage in Induced Labor in Term Pregnant Women with Gestational Hypertension or Non-Severe Preeclampsia

作　　者：曹品 王蕾蕾[1] CAO Pin;WANG Leilei(Department of Obstetrics,Shengjing Hospital of China Medical Universito,Shenyang Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院产科,辽宁沈阳110004

出　　处：《实用妇产科杂志》2022年第9期689-693,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨足月妊娠期高血压及非重度子痫前期患者引产中严重产后出血的危险因素。方法:回顾性分析2016年1月1日至2020年12月31日于中国医科大学附属盛京医院住院的足月妊娠期高血压、非重度子痫前期并选择引产终止妊娠的患者370例的临床资料,依据产后血红蛋白(Hb)下降情况(Hb下降40 g/L为严重产后出血)分成严重产后出血组(59例)和非严重产后出血组(311例);使用单因素及多因素分析确定妊娠期高血压及非重度子痫前期引产终止妊娠者严重产后出血的危险因素。结果:①5年来足月妊娠期高血压及非重度子痫前期患者中引产及引产后发生严重产后出血的比例基本上呈逐年上升趋势,选择引产终止妊娠者中严重产后出血的发生率为15.95%(59/370)。②严重产后出血组中经阴道分娩率、器械助产率、分娩中应用缩宫素率及引产开始到分娩时间均高于非严重产后出血组,差异有统计学意义(P<0.05)。③Logistic回归分析显示,经阴道分娩(OR5.737,95%CI 2.201~14.956)、器械助产(OR75.627,95%CI 6.140~931.543)及分娩中应用缩宫素(OR2.623,95%CI 1.085~6.342)为严重产后出血的独立危险因素(P<0.05)。结论:足月妊娠期高血压及非重度子痫前期患者的引产率逐年上升,应关注严重产后出血的发生,而经阴道分娩、器械助产、缩宫素的使用增加了严重产后出血发生的风险,应早期识别、及时干预。Objective:To explore the risk factors for severe postpartum hemorrhage in induced labor with full-term gestational hypertension or non-severe preeclampsia.Methods:The clinical data of 370 patients with full-term gestational hypertension or non-severe preeclampsia who were hospitalized in Shengjing Hospital of China Medical University from January 1,2016 to December 31,2020 and selected induced labor to terminate pregnancy were analyzed retrospectively.Patients were divided into severe postpartum hemorrhage group(59 cases)and non-severe postpartum hemorrhage group(311 cases)according to the decrease of postpartum hemoglobin(the decrease of Hb by 40 g/L was severe postpartum hemorrhage).Univariate and multivariate analysis were used to identify the risk factors for severe postpartum hemorrhage.Results:①In the past 5 years,the proportion of term pregnant women with gestational hypertension or non-severe preeclampsia who selected induced labor to terminate pregnancy and severe postpartum hemorrhage after induced labor were increasing year by year,the incidence of severe postpartum hemorrhage among those who chosed induced labor to terminate pregnancy was 15.95%(59/370).②In the severe postpartum hemorrhage group,the rate of vaginal delivery,assisted delivery,using oxytocin in delivery,and the time from the beginning of induced labor to delivery were all higher than those in the non-severe postpartum hemorrhage group,and the differences were statistically significant(P<0.05).③Logistic regression analysis showed that vaginal delivery(OR5.737,95%CI 2.201-14.956),assisted delivery(OR75.627,95%CI 6.140-931.543)and the use of oxytocin in delivery(OR2.623,95%CI 1.085-6.342)were independent risk factors for severe postpartum hemorrhage(P<0.05).Conclusions:The rate of induced labor in patients with full-term gestational hypertension and non-severe preeclampsia is increasing year by year,and attention should be paid to the occurrence of severe postpartum hemorrhage.While vaginal delivery,assisted delivery,and the use of o

关 键 词：严重产后出血 妊娠期高血压 非重度子痫前期 引产 

分 类 号：R714.24[医药卫生—妇产科学]