Intractable Postpartum Hemorrhage Risk Factors And Treatment Of Investigation

Objective:Investigate risk factors that affect intractable postpartum hemorrhage to provide theoretic basis for the prevention and treatment of various risk.factors.Method:Retrospective analysis of 15475 cases of delivery from Jan.2010 to Dec.2013 in our hospital, including 1387 cases of postpartum hemorrhage whose total incidence rate was 8.96% and 162 cases of intractable postpartum hemorrhage, accounting for 11.7% of postpartum hemorrhage. Choosing 162 patients of intractable postpartum hemorrhage to form the observation group and randomly selecting 162 patients who give birth at the same period and have symptoms of tractable postpartum hemorrhage to form the contrast group. Then I collect relevant factors of two groups, including age, gravidity and parity history, abnormal labor, uterine contraction, placental factors, coagulation function, number of fetuses, maternal occupation, macrosomia, complication of pregnancy, the gender of newborn and neonatal health, to conduct a comparison. Furthermore, I divide 162 patients of intractable postpartum hemorrhage into group of cesarean delivery and group of vaginal birth, with the group of cesarean delivery has 115 patients while another group has 47 patients. Meanwhile, 162 patients of tractable postpartum hemorrhage also form group of cesarean delivery (including 30 patients) and group of vaginal birth (including 132 patients). For these patients, we respectively take medication (including oxytocin, ergobasine, carbetocin, misoprostol, carboprost methylate, romethamine, carboprost, tranexamic acid, hemocoagulase and recombinant activated factor VII, etc) and surgery after failed drug treatment (including Bakri balloon, B-Lynch suture, Uterine artery ligation, interventional and hysterectomy)were compared using the therapeutic effects of different treatment methods.Result:(1) From the analysis of observation group and contrast group, I find that patients of the two groups are different in maternal age, uterine inertia, birth canal injury, abnormal labor, placental factors, coagulation disorders, neonatal malformation and complication of pregnancy(P<0.05). After selecting these factors as variables and performing a multivariate Logistic regression analysis, I conclude that risk factors of intractable postpartum hemorrhage including uterine inertia, coagulation disorders, placental factors, complication of pregnancy, neonatal malformation, older age, the past history of abortion, multiple pregnancy and elective caesarean section. Besides, the mode of delivery and maternal occupation are the protective factors of postpartum hemorrhage. (2) Intractable postpartum hemorrhage and tractable postpartum hemorrhage are respectively divided into group of cesarean delivery and group of vaginal birth, and the two groups are statistically significant from the perspective of treatment (P<0.05).Conclusion:Postpartum hemorrhage is the result of multiple factors. Consequently, it’s essential to identify risk factors and take precautions to reduce the incidence of postpartum hemorrhage. Meanwhile, the emphasis of individualized treatment and appropriate choice of treatment based on different causes are helpful to reducing maternal mortality.