Boyle R K, Waters B A, O'Rourke P K
Department of Obstetric Anaesthesia, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2009 Dec;49(6):627-30. doi: 10.1111/j.1479-828X.2009.01089.x.
This study was undertaken to determine if the need for red cell blood transfusion in placenta praevia could be predicted.
Data from a retrospective observational study of 246 obstetric patients, with placenta praevia, from 1999 to 2005 were analysed to generate a model to predict requirement for transfusion.
Seventy-one patients were transfused. Independent risk factors for transfusion were gestational age at delivery of 32-35 weeks [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.1-6.4] and caesarean combined with hysterectomy (OR: 29.4; 95% CI: 5.9-145.9; P < 0.001). No independent risk of transfusion was associated with maternal age, race, parity, smoking status, type of anaesthesia, caesarean combined with arterial balloon occlusion, grade of placenta, accreta and previous uterine surgery.
Gestational age at delivery and type of surgery required are predictors of transfusion during caesarean for placenta praevia. Arterial balloon occlusion does not appear to increase transfusion risk and may be considered as one of the techniques in management.
本研究旨在确定前置胎盘患者红细胞输血需求是否能够被预测。
对1999年至2005年246例前置胎盘产科患者的回顾性观察研究数据进行分析，以建立一个预测输血需求的模型。
71例患者接受了输血。输血的独立危险因素为分娩孕周32 - 35周[比值比（OR）：2.6；95%置信区间（CI）：1.1 - 6.4]以及剖宫产联合子宫切除术（OR：29.4；95% CI：5.9 - 145.9；P < 0.001）。输血无独立风险与产妇年龄、种族、产次、吸烟状况、麻醉类型、剖宫产联合动脉球囊阻塞、胎盘分级、植入以及既往子宫手术相关。
分娩孕周和所需手术类型是前置胎盘剖宫产时输血的预测因素。动脉球囊阻塞似乎不会增加输血风险，可被视为管理技术之一。
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