Risk Factors And Prediction For Postpartum Hemorrhage In Vaginal Delivery Of A Single Child

Objectives To study the risk factors for postpartum hemorrhage and severe postpartum hemorrhage in singleton women with transvaginal delivery and to establish a prediction model for severe postpartum hemorrhage.Methods A retrospective analysis was conducted to select 114 postpartum hemorrhage women who delivered at Anhui Maternal and Child Health Hospital from September 2019 to September 2022,namely the postpartum hemorrhage group(114 cases).According to the amount of bleeding,they were further divided into a non severe postpartum hemorrhage group(74 cases)and a severe postpartum hemorrhage group(40 cases).114 non postpartum hemorrhage pregnant women of the same period were selected as the control group.Compare the differences in delivery methods,comorbidities,complications,and preventive medication;The early predictive value of ROC curve assessment of risk factors for severe postpartum hemorrhage.Results The results By univariate analysis,age ≥28 years,assisted pregnancy,macrosomia and so on in the postpartum hemorrhage group were higher than those in the control group,hypertensive disease and traumatic hematoma in pregnancy in the severe postpartum hemorrhage group were higher than those in the nonsevere postpartum hemorrhage group,and the differences were statistically significant(P <0.05).Planned delivery and placental abnormalities were not statistically significant.Logistic regression analysis showed that age ≥28 years old and assisted pregnancy in the postpartum hemorrhage group were higher than those in the control group,hypertensive disease and traumatic hematoma in pregnancy in the severe postpartum hemorrhage group were higher than those in the nonsevere postpartum hemorrhage group,and the differences were statistically significant(P < 0.05).The preventive effect of high-dose and long-acting oxytocin and ergostine was good,and the difference was statistically significant(P < 0.05).The area under the ROC curve(AUC)is 0.584 [95% CI(0.471,0.698)] and0.556 [95% CI(0.442,0.670)].Conclusions When women are ≥28 years old,assisted pregnancy can increase the incidence of postpartum hemorrhage.Hypertensive disorders of pregnancy and postpartum hematoma are risk factors for severe postpartum hemorrhage.Planned delivery,macrosomia,and placental abnormalities do not increase blood loss.High-dose and long-acting oxytocin and ergostine have good preventive effects.The severe postpartum hemorrhage prediction model has predictive value.