早期产后出血的危险因素:一个回顾性,基于人口的队列分析
Avishag Abecassis1, Tamar Wainstock2, Eyal Sheiner1
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
概括
确定产后出血 (PPH) 的危险因素至关重要. 严重的PPH与试管婴儿怀孕,剖腹产前分娩,子宫前,胎盘断裂和子宫破裂有关.
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) 是全球孕产妇发病率和死亡率的一个重要原因.
- 早期识别风险因素对于及时干预和改善结果至关重要.
- 了解PPH严重程度和传递方式的风险因素如何不同,可以完善临床管理.
研究的目的:
- 确定与早期产后出血 (PPH) 相关的危险因素.
- 要确定这些风险因素是否根据出血的严重程度 (轻度与严重程度) 不同.
- 根据分娩方式 (阴道与剖腹产) 检查风险因素的变化.
主要方法:
- 一项基于人口的队列研究包括了所有在三级医疗中心的分娩.
- 分析了早期PPH的风险因素,比较了严重程度和分娩方式.
- 用多个逻辑回归模型来控制混变量.
主要成果:
- 在322,497例分娩中,早期的PPH发生在0.56%;其中28%是严重的.
- 诸如试管婴儿怀孕,先前的剖腹产,妊娠前期,胎盘断裂和子宫破裂等因素与严重的PPH有关.
- 非渐进性分娩,分娩诱导和妊娠年龄大与轻度和严重的PPH有关.
结论:
- 严重的PPH独立地与试管婴儿怀孕,剖腹产前分娩,子宫前,胎盘断裂和子宫破裂有关.
- 试管婴儿怀孕,子宫前期和较大的妊娠年龄是阴道分娩中PPH的危险因素.
- 前胎盘是PPH的风险因素,特别是在剖腹产后.
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