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目的探讨产后出血的原因及预防措施。方法对上海市浦东新区公利医院2010年1月至2012年12月产后出血资料进行回顾性分析。结果 3年产后出血发生率2.4%(112/4 763),出血原因:子宫收缩乏力占75.0%,胎盘因素占16.1%、软产道损伤占8.0%,凝血功能障碍占0.9%。有既往流产史、二产以上、胎儿体重≥4 000g、双胎者产后出血发生率高,分娩方式与发生率差异无统计学意义。产后出血的高危因素为前置胎盘25.0%、巨大儿14.3%、子痫前期10.7%、双胎8.0%和疤痕子宫7.1%等。结论应针对产后出血的原因及高危因素采取有效的预防措施,降低产后出血发生,降低孕产妇死亡率。
Objective To investigate the causes and preventive measures of postpartum hemorrhage. Methods The data of postpartum hemorrhage from January 2010 to December 2012 in Gongli Hospital of Pudong New Area in Shanghai were retrospectively analyzed. Results The incidence of 3-year postpartum hemorrhage was 2.4% (112/4 763). The causes of hemorrhage were: uterine atony of 75.0%, placental factor of 16.1%, soft birth canal injury of 8.0% and coagulation dysfunction of 0.9%. Have a history of previous abortion, more than two births, fetal weight ≥ 4000g, the incidence of postpartum hemorrhage twins were high, the mode of delivery and the incidence was no significant difference. The risk factors for postpartum hemorrhage were placenta previa 25.0%, macrosomia 14.3%, preeclampsia 10.7%, twins 8.0% and scar uterine 7.1%. Conclusion The prevention and treatment of postpartum hemorrhage should be taken to reduce the incidence of postpartum hemorrhage and reduce the maternal mortality rate.