双胞胎怀孕中产后出血的危险因素和出血的严重程度
1Department Obstetrics and Gynaecology, United Christian Hospital, Hong Kong SAR, China.
Hong Kong medical journal = Xianggang yi xue za zhi
|July 27, 2023
概括
双胞胎怀孕与肥胖,试管婴儿受孕,或胎盘前置面临高严重的分娩后出血风险. 早期识别和专业护理对于管理这些高风险怀孕至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖健康 生殖健康
背景情况:
- 产后出血 (PPH) 是双胞胎怀孕的一个重大风险.
- 确定双胞胎主要PPH的特定风险因素对于有针对性的管理至关重要.
- 以前的研究还没有完全阐明双胞胎怀孕中PPH不同程度的风险因素.
研究的目的:
- 评估双胞胎怀孕中产后出血 (PPH) 的危险因素.
- 具体确定双胞胎怀孕中与主要PPH (血液损失>1000毫升) 相关的因素.
- 帮助早期识别PPH高风险双胞胎怀孕.
主要方法:
- 在2009-2018年间在三级产科单位分娩的680例双胞胎怀孕的回顾性队列研究.
- PPH定义为输血≥500毫升,所有PPH (≥500毫升),主要PPH (>1000毫升) 和严重PPH (>1500毫升) 的分类.
- 使用后勤回归分析来确定每个PPH值的显著风险因素.
主要成果:
- 总体PPH发生率为27.8% (轻微PPH20.1%,主要PPH4.4%,严重PPH3.2%).
- 主要PPH (>1000毫升) 的危险因素包括全身麻醉,体外受精,产前出血,胎盘断裂和胎盘前.
- 严重PPH (>1500毫升) 的危险因素包括体外受精,胎盘前和肥胖.
结论:
- 肥胖,体外受精受孕和胎盘前是双胞胎怀孕中严重PPH的重要危险因素.
- 患有这些风险因素的妇女需要在设备齐全的设施中分娩,以便及时管理严重的PPH,包括血液产品的可用性.
- 对于高风险双胞胎怀孕,建议加强监测和准备.
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