| Background and Purpose:PPH (Postpartum hemorrhage, PPH) is a serious complication during delivery.Itrefers to blood loss more than500ml during the delivery within24hours, or morethan1000ml during cesarean section. In total childbirth,the rate of postpartumhemorrhage is2%-3%. A data of World Health Organization published in2005showed that14million women occur postpartum hemorrhage worldwide every year,and in the529000cases of maternal death every year, the rate of postpartumhemorrhage was25%-30%. The incidence of postpartum hemorrhage in differentregions are also different, in North America is only2%to2%, in Asia and Africa is10.45%. Postpartum hemorrhage is the leading cause of maternal death in our country,and at the same time is the main cause of medical disputes in Obstetrics andGynecology department. Postpartum hemorrhage will bring a range of hazards, themost common is hysterectomy, and bring postpartum women great physical andpsychological burden, also lead to the occurrence of DIC, multiple organ dysfunction,and families injury. Therefore, to reduce the incidence of postpartum hemorrhage is aserious problem. Medical personnel to the causes and risk factors associated withpostpartum hemorrhage in-depth understanding and timely clinical treatment for the cause, be active and effective preventive measures to reduce the incidence ofpostpartum hemorrhage and its complications and reduce maternal mortality.In this study, through the analysis of the causes of postpartum hemorrhage,postpartum hemorrhage summary of the relevant factors, and to explore lower rates ofpostpartum hemorrhage treatment and prevention methodsMethods and objects:Collected from January2013to December2013at the Second AffiliatedHospital of Zhengzhou University hospital delivery of maternal7112people, patientshad102cases of postpartum hemorrhage. Which immediately postpartumhemorrhage in90cases,12were late postpartum hemorrhage. The youngest patientwas22years old, the biggest in43years. The least amount of bleeding500ml, up to6000ml. Retrospective analysis of clinical data, grouped according to different criteria,design of statistical tables from a detailed analysis of the relevant aspects of therecording. Using SPSS17.0statistical software for data analysis and processing, usingthe X2test to P <0.05was considered statistically significant.Results:1Cause of postpartum hemorrhage were:(1) Postpartum hemorrhage accounted for55.88%, ranking the first cause ofpostpartum hemorrhage;(2) Postpartum hemorrhage caused by placental factors accounted for41.17%;ranked second in the cause of postpartum hemorrhage, placental factors are placentaaccreta, placenta previa, placenta accreta, placental abruption.(3) Soft birth canal laceration caused by postpartum hemorrhage accounting for1.96%;(4) Coagulation disorders caused by postpartum hemorrhage accounts for0.98%.This information is for pregnant women with thrombocytopenia.2Postpartum hemorrhage related factors are:(1) Mode of delivery: cesarean section postpartum hemorrhage rate was1.99%;natural childbirth postpartum hemorrhage rate was0.71％,The application of χ2-rayinspection methed. P＜0.05. The difference is statistically significant. the highincidence of postpartum hemorrhage of cesarean section than natural childbirth. (2) First-timer-year-old: olderly primiparous postpartum hemorrhage rate was13.64%,The-school-age delivery of maternal postpartum hemorrhage rate was1.36percent. The Fisher exact probability method is adopted, P＜0.05, The difference isstatistically significant, the elderly primiparous Motherhood Maternity higherbleeding.(3) Great children: children who enormous incidence of postpartum hemorrhage10.11%, non-postpartum hemorrhage huge child who was1.32%. The Fisher exactprobability method is adopted, P＜0.05, The difference is statistically significant.the great child who postpartum hemorrhage rate.(4) twin pregnancy: twins who are postpartum hemorrhage was8.13%,non-twins were1.32%incidence of postpartum hemorrhage. The Fisher exactprobability method is adopted, P＜0.05, The difference is statistically significant.Motherhood Maternity twins conceived after high bleeding.(5) Placenta previa: Placenta previa in postpartum hemorrhage in12cases. TheFisher exact probability method is adopted, P＜0.05, The difference is statisticallysignificant. Placenta previa postpartum hemorrhage rate is high.(6) Gestational hypertension: hypertension in pregnancy postpartum hemorrhagerate was4.76%, non-hypertension postpartum hemorrhage rate was1.34%, TheFisher exact probability method is adopted, P＜0.05, The difference is statisticallysignificant. gestational hypertension high incidence of postpartum hemorrhage.(7) other relevant factors: maternal history of abortion accounted for36.27percent of postpartum hemorrhage; pregnant women with anemia accounted for5.88percent of maternal postpartum hemorrhage; pregnancy with fetal abnormalitiesaccounted for8.82percent of maternal postpartum hemorrhage; much amniotic fluidduring pregnancy maternal postpartum hemorrhage accounts for5.88%; less amnioticfluid during pregnancy accounted for4.90percent of maternal postpartumhemorrhage; precious children accounted for2.94percent of maternal postpartumhemorrhage.3The treatment of postpartum hemorrhage:(1) General treatment: during childbirth, once found increased bleeding, uterinemassage immediately line, use of oxytocin, Yan Pei, An Lieke, misoprostol treatment. In this document there are73cases after general treatment to achieve hemostasis.(2) B-Lynch suture: In cesarean section, after the general treatment did notachieve the purpose of immediate hemostasis line B-Lynch suture, there were21cases of successful hemostasis.(3) Transcatheter arterial embolization: delivery after the end of closeobservation, if circumstances continue to have discovered massive bleeding occurs,should be promptly sent to intervene chamber intervention, the purpose of thismethod is to stop the bleeding in14cases.(4) Hysterectomy: method works by more than those who are poor hysterectomyin4cases.4. The prevention of postpartum hemorrhage:6998cases of perinatal maternal conducted, the occurrence of97cases ofpostpartum hemorrhage, the rate was1.39%;114cases of maternal perinatal care isnot carried out, the occurrence of five cases of postpartum hemorrhage, the rate was4.39percent. Be seen after perinatal maternal perinatal care than the bit rate ofMotherhood Maternity bleeding.Conclusion:1.Postpartum hemorrhage is caused by a variety of reasons, the main reason isuterine atony and placental factors.2.The related factors of Postpartum hemorrhage are: uterine scar, mode ofdelivery, the elderly primiparous, placenta previa, a huge children, twins pregnancy,abortion history, pregnancy complications, etc.3.B-Lynch suture and transcatheter arterial embolization are effective methods tothe treatment of postpartum hemorrhage.4.Antenatal, intrapartum and postpartum prevention can effectively reduce theincidence of postpartum hemorrhage and its complications. |
PDF Full Text Request