Dupont C, Rudigoz R-C, Cortet M, Touzet S, Colin C, Rabilloud M, Lansac J, Harvey T, Tessier V, Chauleur C, Pennehouat G, Morin X, Bouvier-Colle M-H, Deneux-Tharaux C
Réseau périnatal Aurore, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; EAM 4128, laboratoire « Santé, Individu, Société », faculté de médecine Laënnec, 69372 Lyon, France.
Réseau périnatal Aurore, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; EAM 4128, laboratoire « Santé, Individu, Société », faculté de médecine Laënnec, 69372 Lyon, France; Université Lyon Est, 69008 Lyon, France.
J Gynecol Obstet Biol Reprod (Paris). 2014 Mar;43(3):244-53. doi: 10.1016/j.jgyn.2013.05.003. Epub 2013 Jun 19.
To estimate the incidence, to describe the aetiology and to identify the risk factors of postpartum haemorrhage (PPH).
Prospective study conducted in 106 French maternity units of six perinatal networks between December 2004 and November 2006. PPH was defined by a blood loss superior to 500 mL or necessitating an examination of the uterus, or a peripartum haemoglobin drop superior to 2 g/dL. Severe PPH was defined by at least one of these criteria : peripartum haemoglobin drop superior or equal to 4 g/dL, embolization, conservative surgical procedure, hysterectomy, transfusion, transfer to intensive care or death.
The incidence of PPH was 6.4% [CI 95% 6.3-6.5] with variations between maternity units from 1.5% to 22.0%; incidence of severe PPH was 1.7% [CI 95% 1.6-1.8] with variations between units from 0% to 4%. Atony was the main aetiology of PPH, whatever the mode of delivery and severity. The risk factors identified were those classically described in the literature.
In these six French perinatal networks, in 2005-2006, the PPH profile was characterized by an incidence of severe forms higher than previous population-based estimates from other countries. This suggests a more frequent aggravation of PPH and the implication of inadequate PPH management.
评估产后出血（PPH）的发生率，描述其病因并确定相关危险因素。
2004年12月至2006年11月期间，在法国六个围产期网络的106个产科单位进行了一项前瞻性研究。PPH定义为失血量超过500 mL或需要进行子宫检查，或产后血红蛋白下降超过2 g/dL。严重PPH定义为符合以下至少一项标准：产后血红蛋白下降大于或等于4 g/dL、栓塞、保守性手术、子宫切除术、输血、转入重症监护或死亡。
PPH的发生率为6.4% [95%置信区间6.3 - 6.5]，各产科单位之间的发生率在1.5%至22.0%之间；严重PPH的发生率为1.7% [95%置信区间1.6 - 1.8]，各单位之间的发生率在0%至4%之间。无论分娩方式和严重程度如何，宫缩乏力是PPH的主要病因。所确定的危险因素为文献中经典描述的那些因素。
在这六个法国围产期网络中，2005 - 2006年期间，PPH的特征是严重形式的发生率高于其他国家先前基于人群的估计。这表明PPH加重的情况更为频繁，且存在PPH管理不当的问题。
