Xiong Q, Zhang G Y, Chen H C
Second Affiliated Hospital, West China University of Medical Sciences, Chengdu.
Zhonghua Fu Chan Ke Za Zhi. 1994 Oct;29(10):582-5, 635.
Sixty variables during pregnancy, labor and delivery of 951 rural women were analyzed to identify the risk factors of postpartum hemorrhage. The result showed that uterine atony (RR = 13.30, 95% CI = 8.23-21.50) and its related factors were the major risk factors of postpartum hemorrhage. The related factors included prolonged labor (3.49, 1.98-6.15), prolonged second stage of labor (2.72, 1.54-4.78), pregnancy induced hypertension (mild 2.35, 1.11-4.99; > or = moderate 3.04, 1.38-6.70), neonatal weight > or = 3.500 g (2.55, 1.66-3.91). Another category of postpartum hemorrhage risk factors were placental factors (6.32, 2.35-17.01), the third stage of labor > or = 10 minutes (2.65, 1.74-4.01), parity > or = 2 (2.61, 1.69-4.01) and maternal age > or = 30 (2.19, 1.13-4.24). The authors recommends that the stress should be put on the management of labor and delivery, to prevent and management of postpartum hemorrhage, through training the birth attendants to promote their ability to prevent and manage uterine atony and correct management of labor and delivery.
对951名农村妇女妊娠、分娩及产时的60个变量进行分析,以确定产后出血的危险因素。结果显示,子宫收缩乏力(RR = 13.30,95% CI = 8.23 - 21.50)及其相关因素是产后出血的主要危险因素。相关因素包括产程延长(3.49,1.98 - 6.15)、第二产程延长(2.72,1.54 - 4.78)、妊娠期高血压(轻度2.35,1.11 - 4.99;中度及以上3.04,1.38 - 6.70)、新生儿体重≥3500g(2.55,1.66 - 3.91)。另一类产后出血危险因素为胎盘因素(6.32,2.35 - 17.01)、第三产程≥10分钟(2.65,1.74 - 4.01)、产次≥2(2.61,1.69 - 4.01)及产妇年龄≥30岁(2.19,1.13 - 4.24)。作者建议应重视分娩管理,通过培训助产人员提高预防和处理子宫收缩乏力的能力以及正确处理分娩,来预防和处理产后出血。