浅析晚期产后出血的原因及防治

摘要

目的：探讨晚期产后出血时间、病因及防治措施。方法：对2008年1月至2012年12月收治的20例晚期产后出血病例进行回顾性分析。结果：19例晚期产后出血患者痊愈出院，1例抢救无效死亡。发病原因依次为：子宫复旧不良，胎盘胎膜、蜕膜残留，切口裂开或血肿，软产道裂伤，产后绒癌。发生时间以产后1.5天至2周者占多数（65%），少数病例﹥6周（5%）。结论：晚期产后出血的时间不应局限于产褥期内，其主要病因为子宫复旧不良和胎盘、胎膜及蜕膜残留；为了减少和避免晚期产后出血的发生，加强孕期保健、严格掌握剖宫产指征及时机、正确处理第三产程是关键。%Objective:To investigate the time of late postpartum hemorrhage and its etiologyand treatment.Methods Clinical data of 20 cases of late postpartum hemorrhage from 2008 to 2012 were analyzed retrospectively .Results 19 cases of late postpartum hemorrhage were recovered, but one case was unable to save.Sub involution of uterus were tops the list of causes,fllowed by residual placenta and membranes or decidua,dehiscence of incision or hematoma,aceration of birth canal, postpartum choriocarcinoma.In most cases(65%),postpartum haemorrhage will occur after 1.5-2 days after childbirth and a few(5%) will occur after 6 weeks .Conclusion Late postpartum hemorrhage may occur beyond puerperium and the main causes are sub involution of uterus and residual placenta and membranes or decidua. In order to reduce or avoid the incidence of late postpartum hemorrhage, it is the key to strengthen maternal care, master the indication for cesarean section strictly and also deal with the third stage of labor correctly.