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产后出血的发病率基于改进的联合方法来评估血液损失:一个回顾性队列研究

Fangyuan Zheng¹, Haiyan Wen¹, Lan Shi²

¹Department of Obstetrics, Hangzhou Women's Hospital, Hangzhou, China.

|July 28, 2023

概括

这项研究发现,子分娩和剖腹产会增加产后出血风险. 子宫是主要的原因,在分娩方式之间存在不同的因素.

科学领域:

产科和妇科产科和妇科
孕产妇健康孕产妇健康
管理出血管理出血

背景情况:

产后出血 (PPH) 失血的临床评估通常是不准确的.
准确的PPH量化对于及时有效的管理至关重要.
不同的传递方式可能会影响PPH发生率和特征.

研究的目的:

调查PPH的发病率,病因和临床特征.
在不同的分娩方式 (阴道,子,剖腹产) 中比较PPH.
评估一种改进的组合方法,用于评估PPH中的血液损失.

主要方法:

从2020年1月到2021年6月,对18977名分娩者进行了回顾性队列研究.
包括725个PPH病例.
采用了体积,重度和面积的综合方法来评估血液损失.

主要成果:

PPH发生率为3.8%,严重的PPH为0.4%.
按分娩显示PPH发生率明显高于阴道分娩 (P<0.001).
剖腹产的严重PPH发病率明显高于阴道分娩 (P=0.003).
根据传递方式,PPH的原因有很大差异 (P<0.001).
剖腹产组需要显著更多的输血 (P<0.001).

结论:

强迫分娩和剖腹产与PPH风险增加有关.
子宫是PPH的主要原因,在手术分娩中,出生通道破伤和胎盘因素是重要的.
联合血液损失评估方法证明了临床实用性,但需要进一步改进以提高准确性.

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