Logistic regression analysis of related risk factors of obstetric emergency hysterectomy / 中国基层医药

ABSTRACT

Objective To investigate the incidence rate and risk factors of obstetric emergency hysterectomy.Methods The clinical data of childbirth puerpera in Shangqiu four municipal hospitals were retrospectively analyzed,80 patients underwent routine obstetric emergency hysterectomy were selected as hysterectomy group,56 postpartum hemorrhage patients without uterus excision were randomly selected as control group.The related risk factors of obstetric emergency were analyzed.Results (1) The total delivery number was 65 259 cases,cesarean rate was 47.46％ (30 972/65 259),postpartum hemorrhage rate was 4.61％ (1 429/30 972),and uterus removal rate of cesarean section was 0.18％ (56/30 972),vaginal delivery postpartum hemorrhage rate was 3.28％ (1 124/34 287),in the courtyard the vaginal delivery emergency uterus removal rate was 0.03％ (12/34 287).The postpartum hemorrhage rate and obstetrics emergency uterus removal rate were higher than vaginal delivery,the differences were statistically significant (x2 =77.22,33.24,all P ＜ 0.05).(2) The results of the single factor analysis showed that,placenta previa and implant,placental abruption,merge multiple or huge uterine fibroids,uterine rupture,blood coagnlation dysfunction,armount of bleeding ＞ 2 000ml,vanda operation with oxytocin rate between the two groups,there were significant differences(P ＜ 0.01).(3) The results of unconditional multi-factor Logistic regression analysis showed that,placental abruption,uterine rupture,merge multiple or huge uterine fibroids,blood coagulation dysfunction,amount of bleeding ＞ 2 000ml were independent risk factors which lead to obstetric emergency hysterectomy.Vanda operation with oxytocin and hysterectomy had negative correlation.Conclusions Obstetric emergency hysterectomy was related with a variety of factors.Strengthen the perinatal health care,and actively prevent emergency hysterectomy can reduce the dangerous factors of uterus removal rate and has important significance.