Clinical Analysis Of 221 Cases Of Postpartum Hemorrhage

ObjectiveTo analyze the causes of postpartum hemorrhage(PPH),and to talk about the risk factors and effective treatment of postpartum hemorrhage.MethodsA large sample for retrospective analysis was applied with epidemiological methods,and 221 cases of postpartum hemorrhage selected from Beijing Military General Hospital for treatmeting from January 2013 to December 2014 was treated as research object.those factors were treated with retrospective analysis,such as the reasons,risk factors,amount of bleeding,bleeding time and treatment of postpartum hemorrhage.Results1.The rate of postpartum hemorrhage was 4.19 percent(221/5272),and 199 cases occurred within two hours of the fetus coming,22 cases occurred within form two hours to twenty-four hours.2.Causes of postpartum hemorrhage were:(1)Postpartum of uterine contractions fatigue accounted for 71.04 percent,ranking the top cause of postpartum hemorrhage;(2)Postpartum hemorrhage caused by placental factors accounted for 19.46 percent,ranking the second cause of postpartum hemorrhage,and the placenta causes include residual placental membranes,placenta accrete,placenta previa,placenta accrete and previa dangerous placenta;(3)Postpartum hemorrhage caused by soft birth canal laceration accounting for 8.14 percent;(4)Postpartum hemorrhage caused by coagulation dysfunction accounting for 0.46 percent,which is acute undifferentiated leukemia in the date;(5)Those postpartum hemorrhage of this paper caused by other factors accounted for 0.9 percent.3.The high-risk factors of postpartum hemorrhage: ⑴mode of delivery:The rate of postpartum hemorrhage by cesarean section was 4.75 percent,and the natural childbirth was 3.56 percent,the difference was statistically significant(P<0.05);⑵primiparous elderly mothers:The rate of postpartum hemorrhage with primiparou elderly persons was 6.17 percent,and school-age deliveries was 4.20 percent,the difference was statistically significant(P<0.05);⑶abortion:The rate of poatpartum hemorrhage with history of abortion was 5.42 percent,and the no history of abortion was 3.54 percent,the difference was statistically significant(P<0.05);⑷weight of newborn neonate:The rate of postpartum hemorrhage with fetal macrosomia was 6.76 percent,and normal weighe children was 3.99 percent,the difference was statistically significant(P <0.05);⑸multiple births:The rate of postpartum hemorrhage with multiple pregnancies was 10.00 percent,and the single pregnancies was 4.15 percent,the difference was statistically significant(P<0.05);⑹uterine scar:The rate of postpartum hemorrhage with uterine scar was 7.66 percent,and the non-uterine scar was 4.51 percnet,the difference was statistically significant(P < 0.05);⑺polyhydramious:The rate of postpartum hemorrhage with polyhydramious was5.70 percent,and the normal amniotic fluid was 4.07 percent,the difference was statistically significant(P < 0.05);⑻pregnancy anemia:The rate of postpartum hemorrhage with pregnancy anemia was 5.81 percent,and the non-anemia during pregnancy was 3.93 percent,the difference was statistically significant(P<0.05);⑼hypertensive disorders complicating pregnancy:The rate of postpartum hemorrhage with hypertensive disorders complicating pregnancy was 6.90 percent,the normal pressure during pregnancy was 4.07 percent,the difference was statistically significant(P < 0.05).⑽High-risk factors(single factor and multiple factors)impact on postpartum hemorrhage rate :There are high risk factors of maternal group,the incidence of postpartum hemorrhage was 4.98%,with no risk factors of maternal group,the incidence of postpartum hemorrhage was 2.20%,the difference was statistically significant(P<0.05).4.The treatment of postpartum hemorrhage,221 cases of postpartum hemorrhage in 192 cases after drug treatment to achieve hemostasis,24 cases to use B-Lynch suture technique to achieve the purpose of hemostasis,1 case of using B-Lynch decompression + intervention to achieve the purpose of the bleeding,3 cases of intervention to achieve hemostasis,1 case of uterus,221 cases after more good.Conclusion1.The incidence of postpartum hemorrhage was 4.19%,which need to cause attaches great importance to;2.Postpartum hemorrhage caused by a variety of causes,which include uterine contractions fatigue,placental factors,soft birth canal laceration and coagulation diaorders,especially uterine contractions fatigue.3.Those high-risk factors leading to postpartum hemorrhage are as follows: cesarean section,the primiparous elderly mothers,history of abortion,weight of newborn neonate,multiple births,uterine scar,polyhydramious,pregnancy anemia and hypertensive disorders complicating pregnancy and so on.4.In the treatment of postpartum hemorrhage,drug treatment can effectively most of the postpartum hemorrhage,application for the hemostatic effect of bad B-Lynch suture and(or)intervention can effectively stop the bleeding,direct hysterectomy when necessary to save lives.