Assessment Of The Amount Of Blood Loss And Risk Factors Of Postpartum Hemorrhage

Objective: Through the comparison of the amount of blood loss by accuratemeasurement and by rough estimate,to show the importance of accurate measurement;Tostudy the related factors of postpartum hemorrhage（PPH）and search for the valuablemethod to predict the PPH with high-risk factor score.Methods:A resrospective analysis of141cases pregnancy women.Analysis the clinicalmanifestation,pregnant condition and complication of pregnancy. Recognize therelated fators of PPH. The logistic regression was used in the analysis of risk factors.The amount of blood loss was measured by the method of weight, volume and rangeestimation.PPH was defined as blood loss≥500ml during24hours after labor. Makea rating scale with fifteen items to evaluate all pregnant women.Then compare theresults of the logistic regression and the amount of blood loss with the scores fromthe rating scale,to get a better rating scale to assist clinicians in the preventionand management of PPH.Result:(1) The average amount of blood loss is418.19±174.08ml, and202.38±92.02mlby rough estimate.27cases of PPH were identified among141deliveries actually, theincidence of PPH being19.15%.and there were just4cases by rough estimate,theincidence of PPH being2.84%. Compared the accurate measurement with roughestimate,we would found the rate by accurate measurement was more than the rate byrough estimate(P＜0.05).(2) Through the related curve analysis，we know that the amount of blood lossby accurate measurement and the error by rough estimate were positivelycorrelated(P＜0.05).（3）There were7factors associated with PPH significantly according to thesingle factoral analysis.They were macrosomia, scar uterus, the prolonged stage oflabor or arrested labor,adherence implantation or residual of placenta,uterine leiomyoma, fundal height,the third stage of labor（4）There were5factors entered the logistic regression model according tomultiple factoral analysis. They were macrosomia（OR=10.361,95%CI2.966～36.197），scar uterus（OR=6.008,95%CI1.473～24.509），the prolonged stage of labor orarrested labor（OR=3.518,95%CI1.356～9.131）， adherence implantation or residualof placenta （OR=2.575,95%CI1.346～4.924），uterine leiomyoma（OR=2.181,95%CI1.192～3.991）。(5)Through the related curve analysis，we know that the amount of blood lossand rating value were positively correlated.Conclusion:(1)It is very important to accurate measurement of the blood loss andit is credible to predict postpartum hemorrhage predictor.(2) The risk factors of PPH including macrosomia, scar uterus, theprolonged stage of labor or arrested labor,adherence implantation or residual ofplacenta,uterine leiomyoma. Controlling Fetal weight and the rate of cesareansection, reducing unwilling pregrancies and induced abortion, active management ofthe stage of labour are all important tominimize the incidence of postpartumhemorrhage and obstetric mortality.