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目的:对初产妇阴道分娩产后出血的原因与危险因素进行总结分析。方法:回顾性分析2011年1月-2014年1月在我院阴道分娩的800例初产妇临床资料。结果:导致初产妇阴道分娩产后出血学的高危相关性因素主要有:流产超过2次、合并妊高症、严重贫血、多胎、第三产程超过15分钟、胎盘因素、宫缩抑制剂不合理使用等。经多因素Logistic回归分析,显示流产超过3次、中重度贫血、合并妊高症、第三产程超过15分钟是产后出血的独立高危因素。结论:初产妇阴道分娩产后出血高危因素较多,孕期要注意预防产后出血的高危因素,对贫血、妊高症等及早处理,分娩过程要重视第三产程,尽量将第三产程时间控制在15分钟内,合理使用宫缩剂,对降低产后出血率有积极意义。
Objective: To summarize the causes and risk factors of postpartum hemorrhage during vaginal delivery in primipara. Methods: A retrospective analysis of January 2011 - January 2014 vaginal delivery in our hospital 800 cases of primipara clinical data. Results: The high risk factors of postpartum hemorrhage caused by vaginal delivery in primipara mainly include abortion more than 2 times, complicated with pregnancy-induced hypertension, severe anemia, multiple births, more than 15 minutes in the third stage of labor, placental factors and irrational use of tocolytic agents Wait. Multivariate Logistic regression analysis showed that miscarriage more than 3 times, moderate to severe anemia, combined with pregnancy-induced hypertension, the third stage of labor more than 15 minutes is an independent risk factors for postpartum hemorrhage. Conclusions: The risk factors of postpartum hemorrhage in primiparous vaginal delivery are more, the high risk factors of preventing postpartum hemorrhage during pregnancy should be noticed, the early treatment of anemia and pregnancy-induced hypertension should be paid attention to, the third stage of labor should be emphasized in the process of delivery, Within minutes, the rational use of uterotonics, to reduce postpartum hemorrhage rate has a positive meaning.