34 沈 宇 清 陈 敦 金 2000 1 2008 6 375 2 Fisher logistic log ey /1 - Y= - 7. 274 + 0. 858 + 0. 821 4 2 2 = 13. 23 P < 0. 01 12 3 2 = 54. 21 P < 0. 01 8 2 = 20. 65 P < 0. 01 6 1 ~ 5 2 = 10. 85 P < 0. 01 8 6 ~ 7 2 = 4. 68 P < 0. 05 12 8 ~ 11 2 = 10. 53 P < 0. 01 Establishment of a severe postpartum hemorrhage and the severe complication prediction scoring system SHEN Yu-qingCHEN Dun-jin. Department of Obstetrics and Gynecologythe Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510150China. Corresponding authorchen Dun-jinEmailchendunjin@ hotmail. com Abstract Objective To provide guideline for the clinical management of postpartum hemorrhage and to build up a scoring system for the prediction of severe postartum hemorrhage. Methods This study reviewed 375 pregnant women with severe postpartum hemorrhagewho were treated on the Third Affiliated Hospital of Guangzhou Medical University from January 2000 to June 2008. Then we analyzed the relationship between scores and the maternal outcomeswhich included organ dysfunctionhysterectomy and deathand established the prediction scoring system for postpartum hemorrhage. The data were analyzed using 2 testfisher exact probability test linear association and logistic regression. Results log ey / 1 - Y = - 7. 274 + 0. 858 prenatal score + 0. 821 postpartum score was the formula of prediction for sever postapartume hemorrhage. The score was 4 which suggested the incresing risk of organ dysfunction 2 = 13. 23 P < 0. 01 and 12 scores suggested the incresing risk of three or more organs dysfunction 2 = 54. 21 P < 0. 01. Over 8 scores suggested the risk of hysterectomy was increased significantly 2 = 20. 65 P < 0. 01. There were significantly difference of serve postpartum hemorrhage between score 6 group and score 1-5 group 2 = 10. 85 P < 0. 01. And sever postpartum hemorrhage also had significant difference between score 8 group and 6-7 group 2 = 4. 68 P < 0. 05 score 12 group and score 8-11 group 2 = 10. 53 P < 0. 01. Conclusions The prediction scoring system can DOI 10. 3877 /cma. j. issn. 2095-3259. 2013. 01. 010 510150 Emailchendunjin@ hotmail. com
35 be used to predict effectively the risk of severe postpartum hemorrhage and evaluate the serious degree of situation. In the further we need a research on a large scale. Key words Postpartum hemorrhage Forecasting Quality indicatorshealth care Pregnancy outcome 24 h 2. 500 ml > 1500 ml 11 logstic 3. 12 1 1 20 20 2000 1 2008 6 375 1. 375 logistic 1 P < 0. 05 25 2 25 3-10 0 ~ 3 43 25 1 0. 821Y 2 log ey /1 - Y= - 7. 274 + 43 1 SPSS 13. 0 Fisher - 7. 274 0. 858 0. 858 + 0. 821 0. 5 86. 7%
36 1 0 1 2 3 16 ~ 35 35 1 0 < 42 42 1 2 3 > 3 1 ~ 3 0 / / 10 9 /L 80 < 80 < 50 20 / cm < 32 32 35 40 / / / / min < 10 10 ~ 14 > 15 > 20 / / / / 13. 23 P < 0. 01 3 12 1. 375 12 14 /32 43. 75% < 12 14 /343 4. 08% 375 2 = 54. 21 P < 0. 01 349 92. 8% 215 57. 33% 2 106 28. 27% 3 28 7. 47% Kendall b = 2 < 1 Fisher 0. 5 2 21 /23 2. 375 91. 30% 1 0 2 = 3. 86 P < 0. 05 2 4 20 /62 32. 26% < 4 5 /69 7. 25% 2 = 0. 564 Spearman b = 0. 677 P < 0. 001 375 89 23. 73% 48 12. 77% 11 2. 93% 3
37 2 2 % % % 1 2 0 0 0 0 0 0 2 23 21 91. 30 0 0 0 0 3 44 36 81. 82 5 11. 36 0 0 4 62 39 62. 90 20 32. 26 0 0 5 50 34 68. 00 10 20. 00 0 0 6 43 22 51. 16 12 27. 91 0 0 7 45 31 68. 89 12 27. 91 2 4. 44 8 31 14 45. 16 12 26. 67 4 12. 90 9 27 11 40. 74 12 44. 44 4 14. 81 10 13 4 30. 77 6 46. 15 3 23. 08 11 3 0 0 2 66. 67 1 33. 33 12 12 0 0 8 66. 67 4 33. 33 13 5 2 40. 00 1 20. 0 2 40. 00 14 5 0 0 2 40. 00 3 60. 00 15 3 0 0 2 66. 67 1 33. 33 16 3 0 0 2 66. 67 1 50. 00 17 2 1 50. 00 0 0 1 100. 00 19 1 0 0 0 0 1 100. 00 20 1 0 0 0 0 1 100. 00 375 215 57. 33 106 28. 27 28 7. 47 3 < 1 Fisher 1 8 7 /31 22. 58% < 8 7 /269 2. 60% 2 = 20. 65 P < 0. 01 2 6 6 /43 13. 95% 1 ~ 5 3 /181 1. 66% 2 = 10. 85 P < 0. 01 8 12 /3138. 71% 6 ~ 7 17 /8819. 32% 2 = 4. 68 P < 0. 05 12 12 /12100% 8 ~ 11 37 /74 50. 00% 2 = 10. 53 P < 0. 01 3 1 2 0 0 0 2 23 0 0 0 3 44 0 0 0 4 62 1 1 0 5 50 2 0 2 6 43 6 1 1 20 90 7 45 11 5 5 8 31 12 7 0 1 9 27 13 6 1 10 13 9 6 0 11 3 3 3 0 12 12 12 7 1 13 5 5 3 1 14 5 5 3 0 15 3 3 2 0 16 3 3 2 0 17 2 2 2 0 19 1 1 0 0 4 20 1 1 1 1 375 89 48 11
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