Analysis Of Clinical Characteristics Of Undiagnosed Abnormal Postpartum Blood Loss During Cesarean Section

[Objective] : Postpartum hemorrhage(PPH)is a common complication in obstetrics.In recent years,with the opening of the national two-child policy and the increase in cesarean section rates,the incidence of postpartum hemorrhage has also increased year by year.Medical staff often can give sufficient attention and treatment to emergency,sudden and massive postpartum hemorrhage,but clinical studies have found that there is a large amount of slow,hidden,and imperceptible postpartum blood loss,which has not been clinically diagnosed,but is determined by hemoglobin Patients have had postpartum hemorrhage,the incidence of this kind of undiagnosed abnormal postpartum blood loss(UPPBL)is much higher than that of clinically diagnosed postpartum hemorrhage,but it is difficult to arouse the attention and attention of medical staff and patients.The lack of effective and timely diagnosis and treatment has a great adverse effect on the physical and mental health of mothers and children.There are some studies on undiagnosed postpartum hemorrhage in vaginal delivery,but there are fewer studies on undiagnosed postpartum hemorrhage in cesarean section.This article studies the incidence of undiagnosed postpartum hemorrhage during cesarean section,and preliminary explores the risk factors of undiagnosed postpartum hemorrhage during cesarean section.The aim is to increase the clinical importance of the diagnosis and treatment of UPPBL in cesarean section,thereby improving the Quality of Life.[Methods] : A total of 861 cases of maternal and childbearing who were hospitalized through cesarean delivery from January 2013 to January 2017 in the First Affiliated Hospital of China Medical University were selected.The hemoglobin level was measured within one week before the operation,and was unified in the first postoperative period.Hemoglobin levels were repeated at 6 am on the 3rd day.The definition of PPH in this article is the bleeding volume of more than 1000 ml within 24 hours after the delivery of a cesareanfetus.UPPBL is defined as a person whose hemoglobin level on the 3rd day after surgery has decreased by more than or equal to 30 g / L from the hemoglobin level within one week before the operation,and who has not been diagnosed with postpartum hemorrhage.According to the definition,the cases were divided into 3groups,including 29 cases of clinically diagnosed postpartum hemorrhage group(PPH group),137 cases of undiagnosed postpartum hemorrhage group(UPPBL group)and 695 cases of control group.A retrospective case analysis study was used to compare the relevant factors in the three groups,including: age,gestational week,pregnancy,parity,preoperative Hb level,neonatal weight and other data,and whether it was associated with pregnancy-induced hypertension and whether Gestational diabetes,premature rupture of membranes,trial production,placental factors,etc.,and observe the incidence of UPPBL and PPH,and analyze the high-risk factors related to the incidence.[Results] : The incidences of UPPBL and PPH in cesarean section in this study were 15.9% and 3.4%,respectively.The incidence of hypertension,placental factors during pregnancy,age,parity,and parity were higher than those of the control group,and the differences were statistically significant.(P <0.05),the incidence of preterm birth was higher in the UPPBL group than in the control group,and the difference was statistically significant(P <0.05),which may be related to complications related to preterm birth.There was no difference in the incidence of preterm birth in the PPH group compared with the control group.Significance(P> 0.05).[Conclusion] UPPBL is a very common complication in cesarean delivery.Its incidence can be as high as 15.9%.It may cause adverse effects on the health of mothers and children,which needs to be taken seriously by clinical staff in clinical work.For pregnant women,age,parity,parity,hypertension during pregnancy,and placental factors are all risk factors for UPPBL in cesarean section.Compared with PPH,preterm birth is an independent risk factor.In clinical work,attention should be paid to pregnant women who are older,pregnant,and have more births,and to strengthen management during pregnancy and intraoperative and postoperative care.For patients with hypertension during pregnancy and who may have placental factors,they should have a good personality in advance.Prevention measures and coping strategies.For preterm pregnant women with selective cesarean section,the incidence of UPPBL may be related to its complications.Intraoperative and postoperative observations need to be strengthened and actively treated to reduce and improve cesarean section.The incidence of undiagnosed postpartum hemorrhage reduces the incidence of maternal and infant complications and improves patient prognosis and quality of life.