分娩期发热产妇产后出血的发生率及影响因素分析-现代医学

分娩期发热产妇产后出血的发生率及影响因素分析

单位：复旦大学附属妇产科医院产房, 上海 200011

分类号：R714.46

出版年·卷·期（页码）：2023·51·第八期（1090-1095）

摘要：

目的：调查分娩期发热产妇产后出血的发生率及影响因素，以期为临床诊疗提供指导并降低该类产妇产后出血的发生率。方法：回顾性选取2021年1月至7月在复旦大学附属妇产科医院进行分娩并且发生分娩期发热的产妇共计867例，收集上述产妇的临床病理特征相关资料。统计分析产后出血的发生与患者临床资料之间的关系，采用二项Logistic回归分析分娩期发热产妇产后出血的独立危险因素。结果：867例分娩期发热产妇中有36例出现产后出血，发生率为4.15%，平均产后出血量为754.03 ml。单因素分析显示产妇年龄≥35岁、初产妇、胎盘异常、产钳助产、妊娠合并巨大儿与分娩期发热产妇产后出血发生率高相关(P＜0.05)，而行急诊剖宫产术的分娩期发热产妇产后出血发生率相对低(P＜0.05)。二项Logistic 回归分析提示产妇年龄≥35岁、胎盘异常、产钳助产是分娩时发热产妇产后出血的独立危险因素，产后出血的风险分别是其对照的3.635、7.516、6.380倍。结论：高龄、胎盘异常及产钳助产因素的分娩期发热产妇发生产后出血可能性较高，应引起产科医护的关注并积极处理，降低产后出血的发生率。

Objective: To investigate the incidence and influencing factors of postpartum hemorrhage in parturient women with fever during childbirth, so as to provide guidance for clinical diagnosis and treatment and to reduce the incidence of postpartum hemorrhage. Methods: A total of 867 parturient women with fever during childbirth in Obstetrics and Gynecology Hospital of Fudan University from January 2021 to July 2021 were selected retrospectively. The clinicopathological characteristics were collected. The relationship between the occurrence of postpartum hemorrhage and the clinicopathological characteristics of patients was statistically analyzed. The independent risk factors of postpartum hemorrhage in parturient women with fever during childbirth were analyzed by bivariate Logistic regression. Results:Among 867 cases, 36 cases had postpartum hemorrhage, the incidence rate was 4.15%, and the average amount of postpartum hemorrhage was 754.03 ml. Univariate analysis showed that maternal age≥35, primipara, abnormal placenta, forceps midwifery, pregnancy complicated with macrosomia were associated with the high incidence of postpartum hemorrhage(P<0.05), while the incidence of postpartum hemorrhage in parturient women with fever during childbirth who underwent emergency cesarean section was relatively low(P<0.05). Bivariate Logistic regression analysis showed that maternal age≥35, abnormal placenta and forceps midwifery were independent risk factors of postpartum hemorrhage. The risk of postpartum hemorrhage was 3.635, 7.516 and 6.380 times higher than those of the control. Conclusion: The parturient women with fever during childbirth who have the factors of advanced age, abnormal placenta and forceps midwifery are more likely to suffer from postpartum hemorrhage, which should be paid attention to by obstetric doctors and nurses to reduce the incidence of postpartum bleeding.

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