Analysis Of Pregnancy Outcomes And Risk Factors Of Postpartum Hemorrhage In Re-cesarean Section

Objective: To retrospectively analyze the pregnancy outcomes of re-cesarean section in patients in our hospital,and to analyze the clinical characteristics of postpartum hemorrhage in patients with re-caesarean section,and to summarize the high-risk factors.Methods: The clinical data of 1,289 patients with re-cesarean section pregnancy in our hospital from 2012.1.1 to 2019.6.30 were selected,and their pregnancy outcomes were compared with that of 2666 patients with first cesarean section in the same period.At the same time,three grouping methods were used for 1289 patients with scar uterus(postpartum hemorrhage 1: bleeding volume ≥1000ml or Hb reduction≥25g / L;postpartum hemorrhage 2: bleeding volume ≥1000ml or Hct reduction≥20%;postpartum hemorrhage 3: Bleeding volume ≥1000ml or Hb drop ≥25g / L and Hct drop ≥20%).Compare the clinical characteristics of postpartum hemorrhage,establish a postpartum hemorrhage model,and analyze the high risk factors of postpartum hemorrhage.Results: The study included a total of 1289 cases with re-cesarean section and 2666 cases with first cesarean section control group.It was found that the scar uterus group had a large number of previous abortions,a high preoperative ultrasound showed a high placental previa ratio,a placenta implantation during operation,and a postpartum hemorrhage ratio.High(P <0.05).Scarred uterine patients with postpartum hemorrhage have many previous miscarriages and more cesarean sections.Preoperative ultrasound showed a high percentage of placenta previa and low placenta.It was found that placenta implantation,application of Xinmupei,and postpartum uterine clearance were significantly higher.In the control group(P <0.05).Analysis of multiple models showed that the bleeding volume was ≥1000ml or Hct decreased by ≥20%.The data model established can better assess postpartum hemorrhage.The number of previous abortions,the normal placenta position,and placental implantation are the top three factors that affect postpartum hemorrhage.The normal placental position is a protective factor.Conclusion: The placental position should be fully evaluated before the second cesarean section in patients with scary uterus,and the corresponding prevention and treatment plan should be made,especially postpartum hemorrhage observation and evaluation as soon as returning to the ward.