Related factors of maternal near miss from obstetric hemorrhage in Henan Province, 2012—2015

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Objective To analyze the results of maternal near miss (MNM) monitoring in Henan Province from 2012 to 2015, so as to discuss the related factors, and to further improve the treatment level of obstetric hemorrhage and reduce the incidence of critical and maternal complications. Methods A retrospective analysis was carried out on the monitoring data from 16 592 cases of obstetric hemorrhage at 32 MNM monitoring sites in Henan Province from 2012 to 2015. Results In the analysis of related factors of obstetric hemorrhage, clinical data of 157 824 pregnant women with complications showed that the incidences of complications, in 2012 to 2015, were 19.8%, 26.0%, 31.0% and 37.6%, respectively, increased year by year (Z=-106.4524, P<0.001). The incidences of MNM in the four years were 2.4%, 1.8%, 1.6% and 1.5% respectively decreased year by year (Z=8.8717, P<0.001). Analysis results from 6 592 cases of obstetric hemorrhage showed that, correlation factors of obstetric hemorrhage were placenta previa (29.48%), bleeding (27.21%), uterine atony (19.21%), placental abruption (9.30%), ectopic pregnancy (7.14%), placenta retention (3.01%), bleeding caused by other causes (2.42%), uterine rupture (1.15%), consequently. Conclusions The incidence of severe maternal complications in Henan Province increased year by year from 2012 to 2015, and the incidence of MNM decreased year by year; the incidence of obstetric hemorrhage, except in 2012 (influenced by the quality of monitoringthe early), declined year by year, and occurrence rate of placenta previa caused obstetric hemorrhage increased year by year, which has become an important factor leading to maternal obstetric hemorrhage. Therefore, the relevant professional knowledge of obstetric medical personnel should be further strengthened and trained to standardize the diagnosis, treatment and referral process, and improve the intervention measures. Moreover, medical personnel should have the ability to accurately identify complications of pregnancy in time to perform obstetric hemorrhage treatment as early as possible, and reduce incidence of obstetric hemorrhage. Key words: Obstetric hemorrhage; Maternal near miss; Intervention measure