Clinical analysis of 40 cases of severe postpartum hemorrhage

Abstract:

Objective：To evaluate the risk factor and clinical outcome of severe postpartum hemorrhage（PPH） admitted in ICU and treatment for obstetrics emergency cases. Methods：Retrospective analysis was made in 40 cases of severe PPH admitted in The First Affiliated Hospital of Chongqing Medical University from January 2010 to December 2012. Results：Severe PPH cases admitting in ICU accounted for 16.46% of PPH patients（40/243）. Delivery way of all 243 PPH patients was caesarean section. Main reason of se－vere PPH patients admitting in ICU was hemorrhagic shock，followed by placenta increta，cardiac insufficiency，hyperthyroidism com－plicating with mild eclampsism and cardiorespiratory resuscitation. Twenty-four cases（60.00%，24/40） got bleeding over 2 000 ml. Most patients got at least one system or organ dysfunction and diffuse intravascular coagulation（DIC） was the most common. Severe PPH patients were infused with packed red blood cells（2 544.74±1 782.60） ml，plasma（1 484.85±951.0） ml，platelet （2.7±2.3） U and cryoprecipitate（7.30±10.2） U. Fourteen cases（35.00%，14/40） used nasal oxygen catheters for oxygen，4 cases（10.00%，4/40） used non-invasive ventilator，22 cases（55.00%，22/40） used invasive ventilator. Neonatal case-fatality rate in our hospital was 52.63‰. Conclusions：Main reason of severe PPH patients admitting in ICU is hemorrhagic shock. Severe PPH is one of the important causes of DIC.Intensive life support and component transfusion are the important steps to cure severe PPH. Cooperation between ICU staff and obstetrician is also the effective way to treat critical pregnancies.