Wandabwa J, Doyle P, Todd J, Ononge S, Kiondo P
Walter Sisulu University, Private Bag Xl Unitra, Mthatha 5117, South Africa.
East Afr Med J. 2008 Feb;85(2):64-71. doi: 10.4314/eamj.v85i2.9608.
To determine the risk factors for severe postpartum haemorrhage.
A case control study.
Mulago hospital labour wards, Kampala, Uganda.
One hundred and six mothers with severe postpartum haemorrhage were recruited between 15th November 2001 and 30th November 2002 and were compared with 500 women who had normal delivery.
The predictors for postpartum haemorrhage were co-existing hypertension (O.R 9.3, 95% CI: 1.7-51.7), chronic anaemia (OR 17.3, 95% CI: 9.5-31.7), low socio economic background (OR 5.3, 95% CI: 3.0, 9.2), past history of postpartum haemorrhage (OR 3.6, 95% CI: 1.1-11.8), previous delivery by Caesarean section (OR 7.5, 95% CI: 3.5-14.3), long birth interval of more than sixty months (OR 5.2, 95% CI: 2.1-13.0), prolonged third stage (OR 49.1, 95% CI: 8.8-342.8) and non use of oxytocics (OR 4.3%, 95% CI: 1.2-15.3).
Severe postpartum haemorrhage is common in our environment and is associated with a high maternal morbidity and mortality. The determinants of postpartum haemorrhage are useful in identifying mothers at risk and together with the services of a skilled birth attendant at delivery will prevent postpartum haemorrhage and reduce the maternal morbidity and mortality associated with this condition. In our study, the following risk factors were identified: pre-existing hypertension, chronic anaemia, low socio-economic background, history of postpartum haemorrhage, previous delivery by Caesarean section, longbirth interval of more than sixty months, prolonged third stage and non use of oxytocics were found to be significant.
确定严重产后出血的危险因素。
病例对照研究。
乌干达坎帕拉穆拉戈医院产房。
2001年11月15日至2002年11月30日期间招募了106例严重产后出血的母亲，并与500例正常分娩的妇女进行比较。
产后出血的预测因素包括并存高血压（比值比9.3，95%可信区间：1.7 - 51.7）、慢性贫血（比值比17.3，95%可信区间：9.5 - 31.7）、社会经济背景差（比值比5.3，95%可信区间：3.0，9.2）、既往产后出血史（比值比3.6，95%可信区间：1.1 - 11.8）、既往剖宫产史（比值比7.5，95%可信区间：3.5 - 14.3）、生育间隔超过60个月（比值比5.2，95%可信区间：2.1 - 13.0）、第三产程延长（比值比49.1，95%可信区间：8.8 - 342.8）以及未使用宫缩剂（比值比4.3%，95%可信区间：1.2 - 15.3）。
严重产后出血在我们的环境中很常见，并且与高孕产妇发病率和死亡率相关。产后出血的决定因素有助于识别有风险的母亲，并且与分娩时熟练助产士的服务一起将预防产后出血并降低与此病症相关的孕产妇发病率和死亡率。在我们的研究中，确定了以下危险因素：既往高血压、慢性贫血、社会经济背景差、产后出血史、既往剖宫产史、生育间隔超过60个月、第三产程延长以及未使用宫缩剂被发现具有显著性。
