Analysis of influencing factors on massive hemorrhage during elective cesarean section in patients with placenta previa

Abstract

Objective To explore the influencing factors of massive hemorrhage during elective caesarean section in pregnant woman with placenta praevia. Methods A total of 105 puerperas who were underwent elective caesarean section with placenta praevia in Obstetrics Department of Yan′an University Affiliated Hospital from April 2004 to February 2014, were chosen as study objects.According to the blood loss volume during elective caesarean section, they were divided into massive hemorrhage(MH) group(n=47, the average blood loss volume was 2 054 mL during elective caesarean section) and non-massive hemorrhage (NMH) group(n=58, the average blood loss volume was 540 mL during elective caesarean section). Retrospective cohort study was used to research the maternal medical records, and used statistical method to compare the differences between two groups of puerperas in maternal age, body mass index(BMI), obstetric history, hemoglobin(Hb) content, the highest diastolic and systolic blood pressure during pregnancy etc., used unconditional multivariate logistic regression analysis to assess the independent factors for massive hemorrhage during elective caesarean section in pregnant woman with placenta praevia. All subjects of this study have signed the informed consent forms, and got the approval of Yan′an University Affiliated Hospital Ethics Committee. Results ① The proportion of caesarean section maternal age ≥ 34 years old and the incidence rate of placenta located to anterior in MH group were higher than those of NMH group, but the highest diastolic and systolic blood pressure during pregnancy were lower than those of NMH group, and all the differences above were statistically significant(P 0.05). ② Unconditional multivariate logistic regression analysis results showed that maternal age ≥ 34 years old(OR=2.09, 95%CI: 1.16-3.71, P<0.05) and placenta located to anterior (OR=2.21, 95%CI: 1.21-4.03, P<0.05) were independent risk factors of massive hemorrhage during elective caesarean section in pregnant woman with placenta praevia. Conclusions Pregnant women with placenta praevia are more likely to massive hemorrhage during caesarean delivery when age ≥ 34 years old and placenta located to anterior, so preventive measures should be strengthened. Key words: Placenta previa; Cesarean section; Hemorrhage; Factor analysis, statistical; Puerpera