稽留流产患者药物流产后大出血的高危因素。
High-risk factors for massive haemorrhage in medical abortion patients with missed miscarriage.
机构信息
Department of Family Planning, School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, No. 910 Hengshan Road, Xuhui District, Shanghai, China.
Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.
出版信息
BMC Pregnancy Childbirth. 2024 Sep 9;24(1):521. doi: 10.1186/s12884-024-06682-x.
BACKGROUND
Recently, the incidence of missed miscarriage has gradually increased, and medical abortion is a common method to terminate a pregnancy. In the process of medical abortion, massive vaginal bleeding takes place, leading to emergency surgical haemostasis. Emergency surgery may produce infection and organ damage. Our study aimed to investigate the high-risk factors for massive haemorrhage during a medical abortion.
METHODS
A total of 1062 missed miscarriage patients who underwent medical abortion participated in this retrospective study. According to the amount of bleeding, the patients were divided into a massive haemorrhage group and a control group. By comparing the general conditions of the two groups, such as fertility history, uterine surgery history, uterine fibroids, etc., the high-risk factors for massive haemorrhage during medical abortion were identified.
RESULTS
Relative to the control group, the massive haemorrhage group exhibited a higher proportion of patients with a previous artificial abortion (51.9% vs. 38.1%, P = 0.001). Additionally, the massive haemorrhage group had a lower percentage of first-time pregnant women (32.1% vs. 40.4%) and a higher proportion of women with shorter pregnancy intervals (44.9% vs. 33.1%, P = 0.03). Furthermore, there were notable differences between the two groups regarding maximum fibroid size, the duration of amenorrhea, and gestational week (P < 0.05).
CONCLUSION
In this study, we determined that a history of artificial abortion and an amenorrhea duration of > 11 weeks represented high-risk factors for massive vaginal bleeding during medical abortion in missed miscarriage patients.
背景
近年来，稽留流产的发生率逐渐增高，药物流产是终止妊娠的常用方法，在药物流产过程中会发生大量阴道出血，导致紧急手术止血。急诊手术可能会产生感染和器官损伤。我们的研究旨在探讨药物流产中大量出血的高危因素。
方法
本研究回顾性分析了 1062 例稽留流产患者行药物流产的临床资料。根据出血量将患者分为大量出血组和对照组。比较两组患者的一般情况，如生育史、子宫手术史、子宫肌瘤等，分析药物流产中大量出血的高危因素。
结果
与对照组相比，大量出血组患者中人工流产史比例较高（51.9% vs. 38.1%，P = 0.001），初产妇比例较低（32.1% vs. 40.4%），妊娠间隔较短的患者比例较高（44.9% vs. 33.1%，P = 0.03）。此外，两组间最大肌瘤大小、闭经时间和孕周差异均有统计学意义（P < 0.05）。
结论
本研究表明，人工流产史和闭经时间> 11 周是稽留流产患者药物流产中发生大量阴道出血的高危因素。
Zotero 插件