首页|476例中央型前置胎盘的临床特征及产后出血危险因素分析

476例中央型前置胎盘的临床特征及产后出血危险因素分析

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目的 探讨中央型前置胎盘孕妇临床特征及产后出血的高危因素.方法 回顾性研究2013 年1月至2022 年12 月上海交通大学医学院附属国际和平妇幼保健院收治的因中央型前置胎盘经剖宫产分娩的产妇476 例.根据有无剖宫产史,设有剖宫产史为A组(n =156),无剖宫产史为B组(n =320),并根据是否产后出血(≥1 000 mL)分为产后出血组(n =80)和非产后出血组(n =396),分别比较患者的一般情况及妊娠结局,分析产后出血的高危因素.结果 ① 本研究显示A组孕妇年龄、孕产次、人流次数、剖宫产手术时间、术中出血量、输血率、子宫切除率、术后住院时间、早产儿率及新生儿住院率显著高于B组(P<0.05);而B组辅助生殖率及合并子宫内膜异位症率显著高于A组(P<0.05).② 多因素 Logistic 回归分析发现,剖宫产史、前壁胎盘、胎盘植入及产前出血是产后出血的独立危险因素.结论 剖宫产史可显著增加中央型前置胎盘发生早产、产后出血,甚至子宫切除的风险.此外,剖宫产史、前壁胎盘、胎盘植入、产前出血是产后出血的独立危险因素.
Clinical characteristics and risk factors of postpartum hemorrhage in 476 cases of central placenta previa
Objective To explore the clinical characteristics of pregnant women with central placenta previa and the high-risk factors for postpartum hemorrhage.Methods A retrospective study was conducted on 476 women who underwent cesarean section due to central placenta previa admitted to International Peace Maternal and Child Health Hospital from January 2013 to December 2022.According to whether there was a history of cesarean section or not,group A(n =156)had a history of cesarean section,and group B(n =320)had no history of cesarean section.They were divided into postpartum hemorrhage group(n =80)and non postpartum hemorrhage group(n =396)based on whether there was postpartum hemorrhage(≥1 000 mL).The general situation and pregnancy outcomes of the patients were compared,and the high-risk factors for postpartum hemorrhage were analyzed.Results ① This study showed that maternal age,gravidity and parity times,abortion times,cesarean section surgery time,intraoperative bleeding volume,blood transfusion rate,hysterectomy rate,postoperative hospitalization time,premature birth rate,and neonatal hospitalization rate of group A were significantly higher than those of group B(P<0.05);the assisted reproductive rate and incidence of endometriosis in group B were significantly higher than those in group A(P<0.05).②Multivariate Logistic regression analysis found that a history of cesarean section,anterior placenta,placental implantation,and prenatal bleeding were independent risk factors for postpartum hemorrhage.Conclusion A history of cesarean section can significantly increase the risk of premature birth,postpartum hemorrhage,and even hysterectomy in central placenta previa.In addition,a history of cesarean section,anterior placenta,placental implantation,and prenatal bleeding are independent risk factors for postpartum hemorrhage.

history of cesarean sectioncentral placenta previapostpartum hemorrhagerisk factors

魏雪敏、程蔚蔚

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200030 上海,上海交通大学医学院附属国际和平妇幼保健院产科

剖宫产史 中央型前置胎盘 产后出血 危险因素

2024

10.3969/j.issn.1674-4020.2024.03.15

中国计划生育和妇产科
中国医师协会 四川省医学情报研究所

中国计划生育和妇产科

CSTPCD
影响因子：1.116
ISSN：1674-4020
年,卷(期)：2024.16(3)
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