HDP产妇引产中发生严重产后出血危险因素分析  

Analysis of the risk factors of the severe hemorrhage during labor induction of pregnant women with pregnancy-induced hypertension

作　　者：梁晨[1] 胡前前 程骞 LIANG Chen;HU Qianqian;CHEN Qian(East Hospital of Qingdao Municipal Hospital,Qingdao,Shandong Province,266000;Qingdao Municipal Hospital,Shandong Province)

机构地区：[1]青岛市市立医院东院,266000 [2]青岛市市立医院

出　　处：《中国计划生育学杂志》2024年第7期1640-1643,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠期高血压疾病(HDP)孕产妇引产中发生严重产后出血危险因素。方法:选择2020年1月-2022年12月本院接诊的HDP引产孕产妇200例临床资料,根据引产中产后出血情况分为严重出血组(血红细胞下降40g/L)34例,非严重产后出血为对照组(n=166),分析产妇引产中严重产后出血危险因素。结果:单因素分析,两组年龄、体质指数、分娩史、早发型子痫前期、入院血红细胞、引产流产史、分娩孕周、引产方式、营养不良、分娩次数、收缩压、舒张压比较无差异(P>0.05);两组分娩方式、分娩中应用缩宫素、引产开始到分娩时间、新生儿体质量无差异(P<0.05)。多因素非条件logistic分析,分娩方式为剖宫产、分娩中减少应用缩宫素、引产开始到分娩时间较长、新生儿体质量较大、前胎剖宫产均是HDP孕产妇引产中发生严重产后出血的独立危险因素(P<0.05)。结论:HDP孕产妇引产中严重产后出血独立危险因素较多,临床可应针对危险因素进行有效干预。Objective: To study the risk factors of the severe hemorrhage during labor induction of pregnant women with pregnancy-induced hypertension(PIH). Methods: The clinical data of 200 pregnant women with PIH who had been given labor induction from January 2020 to December 2022 were selected in this study. According to the situation of the hemorrhage during labor induction, these women were divided into 34 women with severe hemorrhage(Hb decreased by 40g/L) in group A and 166 women without severe hemorrhage in group B. The risk factors of the severe hemorrhage of the women with PID during labor induction were analyzed. Results: By univariate analysis, there were no significant differences in the age, the body mass index(BMI) value, the history of delivery, the early-onset preeclampsia, the Hb level at admission, the history of induced labor or abortion, the gestational weeks at delivery, the mode of labor induction, the malnutrition rate, the number of deliveries and the values of systolic blood pressure and diastolic blood pressure of the women between the two groups(P>0.05). There were significant differences in the mode of delivery, the application of oxytocin during delivery, the time from induction to delivery and the weight of the newborn of the women between the two groups(P<0.05). Multivariate unconditional logistic analysis showed that the cesarean section, the reduced oxytocin used during labor, the longer time from induction to delivery, the higher neonatal weight and the cesarean section history of the women with PIH were all the independent risk factors of their severe hemorrhage during induced labor(P<0.05). Conclusion: There are many independent risk factors of the severe postpartum hemorrhage of the pregnant women with PIH, so the effective interventions should focus on these risk factors for the women with PIH in clinic.

关 键 词：妊娠期高血压疾病 引产 严重产后出血 危险因素 

分 类 号：R714.461[医药卫生—妇产科学] R714.246[医药卫生—临床医学]