283例中央性前置胎盘产后出血高危因素分析

发布时间：2018-08-26 18:07

【摘要】：目的:观察中央性前置胎盘的临床表现及结局,探讨其产后出血的高危因素。方法:回顾性分析我院2006年9月至2015年6月283例中央性前置胎盘患者的临床资料,根据是否并发产后出血而分为2组。结果:产后出血组114例,产后未出血组169例;产后出血组的产前出血率、人工流产史发生率以及并发胎盘粘连、胎盘植入率均显著高于产后未出血组(P0.05);Logistic回归分析表明,双胎(OR=10.94,95%CI:1.120~106.871)、妊娠期合并胎盘粘连(OR=4.11,95%CI:0.946~17.852)、产前出血(OR=2.60,95%CI:1.328~5.089)、产检次数(OR=1.13,95%CI:1.026~1.243)以及并发贫血(OR=2.37,95%CI:1.078~5.206)均是孕产妇发生产后出血的高危险因素,而高龄初产(OR=0.35,95%CI:0.117~1.057)、妊娠期合并瘢痕子宫(OR=0.285,95%CI:0.057~1.441)为中央性前置胎盘并发产后出血的保护因素。结论:中央性前置胎盘常并发多种不良妊娠结局;双胎、妊娠期合并胎盘粘连、产前出血、并发贫血等可能为其并发产后出血的高危因素,高龄初产、妊娠期合并瘢痕子宫可能是中央性前置胎盘并发产后出血的保护因素。
[Abstract]:Objective: to observe the clinical manifestation and outcome of central placenta previa and to explore the high risk factors of postpartum hemorrhage. Methods: the clinical data of 283 patients with central placenta previa from September 2006 to June 2015 were analyzed retrospectively. Results: there were 114 cases of postpartum hemorrhage group and 169 cases of postpartum unhaemorrhage group, the rate of postpartum hemorrhage, the incidence of induced abortion and the incidence of placental accretion in the group of postpartum hemorrhage were significantly higher than those in the group without postpartum hemorrhage (P0.05) logistic regression analysis. Twin pregnancy (OR=10.94,95%CI:1.120~106.871), pregnancy with placenta adhesion (OR=4.11,95%CI:0.946~17.852), prenatal hemorrhage (OR=2.60,95%CI:1.328~5.089), times of birth examination (OR=1.13,95%CI:1.026~1.243) and anemia (OR=2.37,95%CI:1.078~5.206) were all high risk factors for postpartum hemorrhage. In OR=0.35,95%CI:0.117~1.057, pregnancy with scar uterus (OR=0.285,95%CI:0.057~1.441) was the protective factor of central placenta previa complicated with postpartum hemorrhage. Conclusion: central placenta previa is often complicated with various adverse pregnancy outcomes, twin pregnancy, pregnancy with placenta adhesion, antepartum hemorrhage and anemia may be the high risk factors of postpartum hemorrhage. Pregnancy with scar uterus may be a protective factor for central placenta previa complicated with postpartum hemorrhage.
【作者单位】：北京海淀妇幼保健院产科;北京大学公共卫生学院劳动卫生与环境卫生学系;包头医学院公共卫生学院劳动卫生与环境卫生学系;
【基金】：北京市支持海淀区社会事业研发专项项目(s2013009)
【分类号】：R714.22

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