Analysis Of The Clinical Cases Of Ignoring Postpartum Hemorrhage For Vaginal Delivery

Objective: Postpartum hemorrhage(PPH)is the most common cause of maternal transferred to the intensive care unit,is the top of the maternal deaths in our country.Clinical medical staff generally attaches great importance and give early diagnosis to women with a sudden,a lot of,obvious postpartum hemorrhage,especially who with one or more common high risk factors of PPH,such as preeclampsia,forceps midwifery,placenta increta,etc.But doctors often ignore the maternal with non-typical clinical manifestation and seemingly normal,having no clinical diagnosis,according to hemoglobin measurement have been PPH,without blood transfusion,intervention,surgical treatment,etc.The incidence of this part ignoring PPH is far higher than that of the PPH by clinical diagnosis,maternal and neonatal poor prognosis and medical resources loss should not be underestimated.Therefore,The purpose of this paper is to analyze the factors related to ignoring PPH for term pregnancy women through vaginal delivery,explore the prevention and control measures,in order to cause clinical attention for ignoring PPH and provide clinical data and reference to prevent and reduce the ignoring PPH.Methods: this article selects clinical data of 703 cases of the hospitalized maternal through vaginal delivery from The second hospital affiliated to Dalian medical university on January 1,2016 to January 1,2017,measuring hemoglobin levels before and after delivery.In this paper,except for clinical diagnosis of PPH,hemoglobin dropped more than 10g/L called the ignoring PPH,hemoglobin declined in and within 10 g/L is called the non-PPH.A total of 604 cases of eligible patients,including 27 cases of PPH by clinical diagnosis(group A),124 cases of ignoring PPH(group B)and 453 cases of the non-PPH(group C).Taking a research method of retrospective case analysis,related factors in three groups are being compared,including general information: age,gestational age,gravidity,parity;Prenatal factors: pregestational body mass index,index of pregnancy weight growth,hypertensive disorders complicating pregnancy(HDCP),uterine fibroids,gestational anemia,macrosomia;During factors: placenta accreta,increta,residue,retention and delivery way(lateral episiotomy,forceps midwifery,normal childbirth),secondary uterine inertia;Postpartum factors: postpartum urinary retention.The paper is in order to further analyze risk factors related to ignoring PPH without causing enough clinical awareness and attention and to explore the prevention and treatment measures.Results: the results after statistical analysis are as follows:1.General data comparison: The age of pregnancy,gestational age,gravidity of A,B,C three groups had no statistical difference,parity of C group respectively compared with A and B group,the difference was statistical significant.Parity of A,B,C three groups respectively was(1.22±0.42),(1.25±0.43),(1.45±0.58).2.Prenatal factors comparison: The gestational anemia of A,B,C three groups had no statistical difference.The pregestational high body mass index(BMI)and pregnancy BMI growth too much between group B and C,the differences were statistically significant.The HDCP of group A respectively compared with B and C group was statistically difference,the difference between B and C group was no statistically significant.The uterine fibroids?macrosomia of A,B groups respectively compared with C group was statistically different.3.During factors comparison: The secondary uterine inertia of A,B,C three groups was no statistically difference.The placenta accreta,increta,residue,retention and manner of delivery(lateral episiotomy,forceps midwifery,normal childbirth)of A,B,C three groups were statistically different.The placenta factors above respectively between A group and B,C group was statistically significant,between group B and C was no statistical difference.The delivery way of A,B,C three groups was statistically difference.The forceps midwifery proportion in group A was highest,the lateral episiotomy proportion in group B was highest.4.Postpartum factors comparison: The postpartum urinary retention in A,B,C three groups were statistically significant,the difference between group B and C was statistically significant,group A respectively compared with group B and C was no statistical difference.Conclusion: The pregestational obesity,excess weight gain during pregnancy,macrosomia,uterine fibroids,lateral episiotomy,postpartum urinary retention are risk factors related to ignoring postpartum hemorrhage.Parity can reduce the incidence of ignoring postpartum hemorrhage.Weight management make the pregestational weight and gestational weight gain are controlled in the range of normal,reduce the incidence of macrosomia;Actively preventing uterine contractions fatigue for pregnancy with uterine fibroids;Strictly mastering the indications of episiotomy,timing,perineum incision approach,repair technology,improving the elasticity of the perineum;Actively preventing and dealing with postpartum urinary retention.The above measures can significantly decrease the incidence of ignoring postpartum hemorrhage.