Two Child Policy Impact On The Incidence Of Postpartum Hemorrhage And Its Risk Factors

Background and purposePostpartum hemorrhage is a serious complication of childbirth,Four the first cause of the maternal death。Two child policy is a country’ s method in order to deal with an ageing population and family planning policy,from November 2011 the provisions of the state of husband and wife are only children can have two children,shall couples party in December 2013 is an only child can have two children,to the country in October 2015 to implement two child policy,more and more couples choose to have two children.As two child policy fully liberalized,Obstetrics faces not only the problems of increase number of delivery,but also the more high risk pregnancy problems is to face uterine scar pregnancy caused by the high rate of cesarean section,and advanced maternal age,multiple pregnancy,assisted reproductive technology,this is bound to lead to increased incidence of postpartum hemorrhage.In view of this,this study through the retrospective analysis in the patients with postpartum hemorrhage taicang area,among 2007 jan 01 solstice December 31,2016 when two child policy open over ten years,analyzing the change of the incidence and risk factors of postpartum hemorrhage,aims at to provide theoretical basis for the clinical treatment of postpartum hemorrhage.,Reduce the incidence of postpartum hemorrhage And the preventive measures after a two child policy。Materials and methodsCollect 2007 jan 01 solstice December 31,2016,taicang maternity care system registration delivery of maternal,65748 people,among them,1586 cases of postpartum hemorrhage patients diagnosed,2.41%incidence of postpartum hemorrhage,1346 cases of cesarean section and vaginal delivery in 240 cases;The age range of 16-68,28.4±4.92 years on average,The amount of bleeding 500-4700ml.Is bounded With the opening of the two child policy by jan 01,2012 into two groups,2007 jan 01 solstice December 31,2011 for five years as the control group,2012 jan 01 solstice December 31 2016 five years for the team in the future,the two groups of cases of clinical data were retrospectively analyzed,the results using SPSS 19.0 statistical software for data analysis and processing,the count data said by chi-square test,measurement data with mean ± standard deviation(x±s),said by T test.With P<0.05 for the difference was statistically significant.The results of1.Statistics of 65748 cases of pregnant women,postpartum hemorrhage,1586 cases of total,total incidence of postpartum hemorrhage 2.4%;The control delivery number 30114 cases,584 cases of postpartum hemorrhage,postpartum hemorrhage rate 1.94%;The team delivery of 35634 cases and 1002 cases of postpartum hemorrhage,postpartum hemorrhage rate 2.81%,the team the incidence of postpartum hemorrhage is higher than the control group(P<0.05).2.Women vaginal delivery number 36120,240 cases of postpartum hemorrhage occurred,postpartum hemorrhage rate0.66%.Caesarean section maternal number 29628 cases,1346 cases of postpartum hemorrhage occurred,postpartum hemorrhage rate 4.54%,cesarean section incidence of postpartum hemorrhage was higher than vaginal delivery(P<0.05).3.Uterine contractions fatigue cause postpartum hemorrhage(71.37%),placenta factor lead to postpartum hemorrhage(21.89%),soft birth canal laceration caused postpartum hemorrhage(4.22%),coagulation dysfunction lead to postpartum hemorrhage(2.52%),uterine contractions fatigue is a major cause of postpartum hemorrhage.4.The postpartum hemorrhage all ages,age 19 or less 1.97%incidence of postpartum hemorrhage,the control group 1.13%incidence of postpartum hemorrhage,the team 3.11%incidence of postpartum hemorrhage,early pregnancy incidence of postpartum hemorrhage increased(P<0.05);Age is 35 7.47%incidence of postpartum hemorrhage,39 years old of the control group 3.82%incidence of postpartum hemorrhage,the team the incidence of postpartum hemorrhage 10.26%;Age 40 or 21.59%incidence of postpartum hemorrhage,the control group 14.84%incidence of postpartum hemorrhage,the team 24.52%incidence of postpartum hemorrhage,older pregnancy increased the incidence of postpartum hemorrhage(P<0.05).5.uterine scar 4.07%incidence of postpartum hemorrhage,uterine scar with the control group 2.67%incidence of postpartum hemorrhage,the team 4.87%incidence of postpartum hemorrhage,scar uterus increased incidence of postpartum hemorrhage(P<0.05);Pregnancy with macrosomia 4.01%incidence of postpartum hemorrhage,the control group 2.63%incidence of postpartum hemorrhage,the team 5.15%incidence of postpartum hemorrhage,macrosomia increased incidence of postpartum hemorrhage(P<0.05);30.37%incidence of postpartum hemorrhage in twin pregnancies,including control group 24.53%incidence of postpartum hemorrhage,the team 34.15%incidence of postpartum hemorrhage,the increased incidence of postpartum bleeding in twin pregnancies(P<0.05);Severe preeclampsia incidence of postpartum hemorrhage 13.45%,with the control group 9.76%incidence of postpartum hemorrhage,the team the incidence of postpartum hemorrhage(15.51%),severe preeclampsia incidence of postpartum hemorrhage increased(P<0.05);placenta previa 17.14%incidence of postpartum hemorrhage,the control group 12.12%incidence of postpartum hemorrhage,the team 20.00%incidence of postpartum hemorrhage,placenta previa increased incidence of postpartum bleeding(P<0.05).6.Postpartum hemorrhage blood loss,2001-3000 ml,13 cases of control group,45 cases of study group,two groups compare differences statistically significant(P<0.05);8 cases the bleeding>3000 ml,the control group,the group 32 cases,there is statistical significance difference comparing the two groups(P<0.05),postpartum hemorrhage of the bleeding.7.Hysterectomy caused by Postpartum hemorrhage of 29 cases,the uterus resection rate 0.44 ‰,which controls the uterus resection rate 0.37 ‰,the team of the uterus resection rate 0.51 ‰,the team emergency obstetric hysterectomy resection rate was increased.conclusion1.The team the incidence of postpartum hemorrhage was increased;2.The incidence of postpartum hemorrhage of cesarean section was obviously higher than that of vaginal delivery;3.The contractions fatigue and placenta factor was the main reason for the postpartum hemorrhage;4.The young and older pregnancy pregnancy leads to increased incidence of postpartum bleeding;5.Scar uterus,macrosomia,twin pregnancy,severe preeclampsia,placenta previa lead to increased incidence of postpartum bleeding;6.The team postpartum hemorrhage blood loss was increased,emergency obstetric hysterectomy resection rate was increased.