【摘要】 目的 探讨经阴道分娩孕产妇发生严重产后出血（sPPH）的危险因素。方法 回顾性分析石家庄市第四医院2018年1月1日至2022年12月31日5年间经阴道分娩发生产后出血（PPH）产妇的病历资料，其中发生sPPH238例作为研究组，采用配对法进行研究，选取非sPPH 221例作为对照组，利用统计学方法分析经阴道分娩发生sPPH的危险因素。结果 单因素分析结果显示，孕妇体重增加、新生儿体重、居住地、总产程、妊娠期高血压、助产情况以及分娩前血红蛋白、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）等因素，研究组与对照组差异具有统计学意义；logistic回归分析结果显示，新生儿体重、总产程、助产情况、分娩前PT均是sPPH的独立危险因素。结论 经阴道分娩sPPH的发生与新生儿体重、总产程、助产情况、分娩前PT等因素有关，针对这些因素进行防控，可以有效防止发生严重产后出血。更多还原

【Abstract】 Objective To explore the risk factors of severe postpartum hemorrhage in pregnant women undergoing vaginal delivery.Methods A retrospective analysis was conducted on the medical records of postpartum hemorrhage during vaginal delivery at Shijiazhuang Fourth Hospital from January 1,2018 to December 31,2022. Among them,238 cases of severe postpartum hemorrhage during vaginal delivery were selected as the study group. Pairing method was used for the study,and 221 matched cases of no-severe postpartum hemorrhage during vaginal delivery were selected as the control group. Statistical analysis was used to identify the risk factors for severe postpartum hemorrhage during vaginal delivery.Results In univariate analysis,the study group showed statistically significant differences in weight gain,newborn weight,place of residence,total duration of labor,gestational hypertension,midwifery status,and per delivery hemoglobin,PT,APTT compared to the control group. The logistic regression results showed that neonatal weight,total duration of labor,midwifery status,and pre delivery PT were all independent risk factors for severe postpartum hemorrhage.Conclusions The occurrence of severe postpartum hemorrhage during vaginal delivery is related to factors such as birth weight,total duration of labor,midwifery status,and pre delivery PT. Preventing and controling these factors can effectively prevent its occurrence.更多还原