Influencing factors of postpartum hemorrhage in elderly women with second fetus

Abstract

Objective To analyze the influencing factors of postpartum hemorrhage in elderly women with second fetus. Methods The clinical data of 2 156 women with advanced maternal age who had the second natural labor in the Huizhou Maternal and Child Health Family Planning Service Center from January 2016 to December 2018 were retrospectivly analyzed. The amount of postpartum hemorrhage was measured by weighing method, and the amount of bleeding exceeding 500 ml was defined as postpartum hemorrhage. The influencing factors of postpartum hemorrhage in elderly women with second fetus were analyzed. Results The bleed volume of the 2 156 elderly women with second was 200 to 3 900 ml, 102 cases of them had blood loss more than 500 ml, and the incidence of postpartum hemorrhage was 4.73%. Among the 102 cases of postpartum hemorrhage, the uterine contraction was bleeding reason in 69.61% patients, the birth canal injury in 18.63% patients, the placenta factor in 10.78% patients, and coagulopathy in 0.98% patients.Mental tension, history of abortion, history of cesarean section, obstetric complications, multiple pregnancy, and delivery of a large child were risk factors of postpartum hemorrhage in elderly women with second fetus (OR=2.24, 3.03, 6.40, 15.03, 4.87, 7.12, P<0.01). Conclusions Mental stress, history of abortion, history of cesarean section, obstetric complications, multiple pregnancies, and childbirth are all risk factors for postpartum hemorrhage in elderly women with second fetus. Screening of high-risk factors for the second-born mothers with advanced maternal age should be performed to select the appropriate mode of delivery, so as to reduce postpartum hemorrhage rate in clinical. Key words: Older maternal, second fetus; Postpartum hemorrhage; Uterine weakness