International Journal of Clinical Research
International Journal of Clinical Research. 2019; 3: (1) 2; DOI: 10.12208/j.ijcr.20190002 .
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湖北省枣阳市妇幼保健院妇产科
*通讯作者： 李文玉,单位：湖北省枣阳市妇幼保健院妇产科；
目的：分析疤痕子宫阴道分娩及剖宫产产后出血的危险因素。方法：选取2016年1月至2018年1月于我院分娩的疤痕子宫孕妇523例进行回顾性分析。其中245例为阴道分娩，278例为剖宫产，采用容积法+称重法测量产后出血量。产后出血危险因素单因素分析：比较阴道分娩组与剖宫产组产后出血发生率，分析年龄，宫缩剂应用，胎盘粘连，前置胎盘，巨大儿，贫血，凝血功能障碍等因素与产后出血的相关性。产后出血的相关因素多因素分析：单因素分析中对产后出血具有显著影响的因素作为自变量，产后出血作为因变量，采用logistic 模型对两组进行产后出血的多因素分析。结果：疤痕子宫阴道分娩产后出血率低于剖宫产（P<0.05），高龄，前置胎盘，巨大儿，凝血功能障碍为产后出血的独立高危影响因素（P<0.05）。结论：疤痕子宫产妇阴道分娩具有可行性，分娩前需要密切关注年龄，巨大儿，胎盘前置，是否凝血功能障碍，为减少产后出血顺利分娩做好充分准备。
Objective: To investigate the risk factors of postpartum hemorrhage for uterine scar pregnancywith vaginal delivery and cesarean section.Methos:From January 2016 to January 2018,523 cases of pregnant women with scar uterus in our hospital wereselected and retrospectively analyzed.245 cases chose vaginal delivery and 278 cases chose cesarean section, and the volume of postpartum hemorrhage was measured by volumetric method and weighing method. Single factor analysis of risk factors of postpartum hemorrhage: comparing the incidence of postpartum hemorrhage in the vaginal delivery group and caesarean section group, the analysis was also made for the correlation between postpartum hemorrhage and age, application of uterine contraction agent, Placental adhesion, placenta previa, macrosomia, anemia, coagulation dysfunction and other factors.Multiple factors analysis of related factors of postpartum hemorrhage: The factors which showed significant influence on postpartum hemorrhage in single factor analysis wereconsidered as independent variables and postpartum hemorrhage was consideredas a dependent variable, and multivariate analysis of postpartum hemorrhage in two groups was made by logistic model.Results:The postpartum hemorrhage ratefor scar uteri with vaginal delivery was lower than that of cesarean section（P<0.05）, besides, advanced maternal age, placenta previa, giant baby, and coagulation dysfunction belonged tothe independent risk factors for postpartum hemorrhage of scar uteri（P<0.05）. Conclusion :Vaginal deliveryfor pregnant woman with scar uteriis practical. It is necessary to pay close attention to the age, the giant baby, the placenta previa, and the coagulation dysfunction before delivery, so as to make full preparation for the reduction of postpartum hemorrhage rate and have the smooth delivery.
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