Cesarean Section Postpartum Hemorrhage Research Articles

Quantitative prediction of postpartum hemorrhage in cesarean section on machine learning

BackgroundCesarean section-induced postpartum hemorrhage (PPH) potentially causes anemia and hypovolemic shock in pregnant women. Hence, it is helpful for obstetricians and anesthesiologists to prepare pre-emptive prevention when predicting PPH occurrence in advance. However, current works on PPH prediction focus on whether PPH occurs rather than assessing PPH amount. To this end, this work studies quantitative PPH prediction with machine learning (ML).MethodsThe study cohort in this paper was selected from individuals with PPH who were hospitalized at Shijiazhuang Obstetrics and Gynecology Hospital from 2020 to 2022. In this study cohort, we built a dataset with 6,144 subjects covering clinical parameters, anesthesia operation records, laboratory examination results, and other information in the electronic medical record system. Based on our built dataset, we exploit six different ML models, including logistic regression, linear regression, gradient boosting, XGBoost, multilayer perceptron, and random forest, to automatically predict the amount of bleeding during cesarean section. Eighty percent of the dataset was used as model training, and 20%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document} was used for verification. Those ML models are constantly verified and improved by root mean squared error(RMSE) and mean absolute error(MAE). Moreover, we also leverage the importance of permutation and partial dependence plot (PDP) to discuss their feasibility.ResultThe experiment results show that random forest obtains the highest accuracy for PPH amount prediction compared to other ML methods. Random forest reaches the mean absolute error of 21.7, less than 5.4%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document} prediction error. It also gains the root mean squared error of 33.75, less than 9.3%\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\%$$\\end{document} prediction error. On the other hand, the experimental results also disclose indicators that contributed most to PPH prediction, including Ca, hemoglobin, white blood cells, platelets, Na, and K.ConclusionIt effectively predicts the amount of PPH during a cesarean section by ML methods, especially random forest. With the above insight, ML predicting PPH amounts provides early warning for clinicians, thus reducing complications and improving cesarean sections’ safety. Furthermore, the importance of ML and permutation, complemented by incorporating PDP, promises to provide clinicians with a transparent indication of individual risk prediction.

Prevalence and Risk Factors of Postpartum Hemorrhage in Cesarean Section: A Retrospective Cohort Study

Prevalence and Risk Factors of Postpartum Hemorrhage in Cesarean Section: A Retrospective Cohort Study

Benefit of Misoprostol with oxytocin for prevention of postpartum hemorrhage in cesarean section

Benefit of Misoprostol with oxytocin for prevention of postpartum hemorrhage in cesarean section

Optimal dose of misoprostol combined with oxytocin for preventing postpartum hemorrhage in cesarean section: A randomised controlled trial

BackgroundThe study analyzed an optimal misoprostol dosage in prevention of postpartum hemorrhage (PPH). Also evaluated the side effects that might be related to dose of misoprostol. Material and methodsA randomised study was performed in mothers who received cesarean section. Participants were divided into 3 groups of 400, 600 and 800 μg intrauterine misoprostol insertion combined with oxytocin. Clinical characteristics, laboratory testing and operative data were collected. The primary outcome was the amount of intra-operative blood loss and side effects were assigned as a secondary outcome. ResultsThere were 357 eligible cases, 119 cases in each group equally. Baseline characteristics were similar in between groups. Higher misoprostol dosage demonstrated lower blood loss. Mean blood loss was 509.1, 465.7 and 441.1 ml in the 400, 600 and 800 μg misoprostol groups respectively which were significant difference (p value 0.027). Post-hoc pairwise t-tests found that 800 μg group diminished blood loss than 400 μg group (p value 0.004). Intra-operative blood loss ≥500 ml occurred less frequently in patients receiving higher misoprostol dosage (p value 0.035). However, PPH was not identified difference between groups (p value 0.707). Nausea and vomiting were complained in less than 1% while none of the cases exhibited shivering. Pyrexia was identified in all groups, however, there was a trend towards lower dosage related to less percentage of pyrexia. ConclusionsEither 400, 600 or 800 μg of misoprostol can prevent PPH similarly. However, the study prefers 400 μg misoprostol because of minimization the side effects.

ROLE OF LOCAL HEMOSTATIC AGENTS AS ADJUVANT IN CONTROL OF PRIMARY POSTPARTUM HEMORRHAGE

Background: Hemostasis is an integral and very important aspect of surgical practice. In the developing world, about 1.2% of deliveries are associated with PPH and when PPH occurred about 3% of women died. Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the four Ts. Objective: To study the effect of gelfoam in hemostasis as adjuvant in control of primary postpartum hemorrhage. Patients and Methods: This was a Cohort study conducted at Sayed Galal University Hospital, Al-Azhar University Faculty of Medicine during the period from May 2019 to May 2020. A number of 60 cases of postpartum hemorrhage and role of gel foam in hemostasis as adjuvant in control of primary postpartum hemorrhage. Results: The findings of the present study indicate that local hemostatic agent “gel foam” was useful as adjuvant in control of primary postpartum hemorrhage in cesarean section. Local hemostats reduce the use of systemic hemostats, shorten the time required to achieve hemostasis. The delay in the recovery of bowel motility was due to the local hypersensitivity reaction caused by gelatin sponge and/or dislocation of this local hemostat. Conclusion: Local hemostatic agent “gel foam” was useful in adjuvant in control of primary postpartum hemorrhage in cesarean section.

The Comparison of the Effect of Carboprost Suppository Combined with Romethamine and Carboprost Suppository Combined with Oxytocin in the Prevention of Hemorrhage after Cesarean Section

The postpartum hemorrhage increases with the increasing use of cesarean section, one of the common methods of delivery. In order to improve the postoperative safety of women with cesarean section, an effective strategy to prevent bleeding after cesarean section is extremely important. This study compares the preventive effects of carboprost with carboprost tromethamine and carboprost with oxytocin on postpartum hemorrhage of cesarean section, which will provide reference for clinical effective prevention of bleeding after cesarean section. A prospective analysis was performed on 349 cases of cesarean section puerperants. According to the treatment method, they were divided into two groups: carboprost suppository combined with oxytocin group (control group) and carboprost suppository combined with romethamine group (study group). The general data, hemodynamic parameters [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and blood oxygen saturation(Sp02)], incidence of adverse reactions, bleeding, uterine recovery and drug efficacy of the patients were compared. There were no differences in hemodynamic indexes between the two groups before medication (P> 0.050). After medication, the HR, SBP, and DBP of the study group were lower than those of the control group, and Sp02 of the study group was higher than that of the control group (P <0.001). The HR and Sp02 of the two groups after medication were higher than those before medication, while the SBP and DBP were lower than those before medication (P <0.050). The total postoperative bleeding volume in the study group was lower than that in the control group (P <0.05); the postoperative bleeding rate in the study group was lower than that in the control group (P <0.05). The uterine return in the study group was better than that in the control group (P <0.05). The total effective rate of the control group was higher than that of the control group (P<0.05). The combination of carboprost suppository and romethamine can better prevent the bleeding after cesarean section, and it is worth popularizing and developing.

Carbetocin Versus Oxytocin for Prevention of Postpartum Hemorrhage in Cesarean Section

Carbetocin Versus Oxytocin for Prevention of Postpartum Hemorrhage in Cesarean Section

Efficacy and Safety of Carbetocin for the Prevention of Primary PPH During Caesarean Section: An Open Label Single Arm Study

Background: The risk of postpartum haemorrhage is much higher for women undergoingcaesarean section, particularly in developing countries where the majority of operations arecarried out as an emergency procedure. Postpartum haemorrhage is the leading cause ofmaternal mortality worldwide. Around 67–80% of cases are caused by uterine atony.Preventive measures include prophylactic drugs use to aid uterine contraction after delivery,thus avoiding severe blood loss and reducing maternal morbidity and mortality. Carbetocin asynthetic analogue of oxytocin is currently indicated for prevention of uterine atony afterdelivery by caesarean section in spinal or epidural anaesthesia.
 The Aim of Study: To see the efficacy and safety of Carbetocin for the prophylaxis of PPHduring caesarean section.Patients and Methods: An open label single arm clinical trial was conducted in the BagerhatSadar Hospital, Bangladesh over a period of six months from May 2017 to October 2017.Ninety patients who had got admitted in Bagerhat Sadar Hospital, undergoing cesareansection at term were selected. Each patient obtained a single dose of 100 microgramcarbetocin intravenously during cesarean section, immediately after the delivery of the babyand prior to the delivery of the placenta. Outcome measures such as primary PPH, bloodloss was observed and measured by weighing sanitary napkin observed for six hours. Needfor additional uterotonic drug, additional blood transfusion as well as adverse effects were alldocumented.
 Results: Massive blood loss occurred only in 3.3% patients. Among the study population96.7% patients did not need any additional uterotonics. No patient had developed fever,arrhythmia, pulmonary edema, tremor, abdominal pain and pruritus. Only 2.2% had nausea,only 3.3% had hypotention, only 3.3% had vomiting and only 2.2% had headache which wasnot statistically significant. Only 4.4% patients developed PPH.
 Conclusion: Carbetocin appears to be an effective new drug for the prophylaxis of postpartumhemorrhage in cesarean section.
 Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 119-124

Uterine compression suture is an effective mode of treatment of postpartum haemorrhage.

Objective:To compare the effects of uterine compression suture versus conventional mode of treatment for the management of postpartum haemorrhage after caesarean section.Methods:This study enrolled 84 women with postpartum hemorrhage who were admitted to Binzhou People’s Hospital from August 2017 to October 2018 as the research subjects. They were divided into a control group and an observation group according to random number table method, 42 each group. The patients in the control group were treated by conventional treatment, while those in the observation group were treated by uterine compression suture. The hemorrhage, hemostasis, postoperative recovery and frequency of adverse reactions were compared between the two groups.Results:The amount of bleeding in the observation group was less than that in the control group, and the bleeding time was shorter than that in the control group; the differences had statistical significance (P<0.05). The success rate of hemostasis in the observation group was significantly higher than that in the control group, and the ineffective rate of hemostasis was significantly lower than that in the control group (P<0.05); the differences were statistically significant. The cleaning time of lochia, the recovery time of uterus and the recovery time of menstruation in the observation group were significantly shorter than that in the control group (P<0.05); the differences between the two groups were statistically significant (P<0.05). The frequency of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05), and the difference was statistically significant (P<0.05).Conclusion:Uterine compression suture is effective for postpartum hemorrhage of cesarean section, which can effectively reduce postpartum hemorrhage, shorten postpartum hemorrhage time and accelerate the recovery. It is safe and worth clinical promotion.

Study on risk factors of postpartum hemorrhage in elderly parturients after cesarean section

Objective To investigate the risk factors of postpartum hemorrhage in elderly parturients after cesarean section based on logistic regression analysis and to explore nursing strategies. Methods From January 2018 to March 2019, a total of 210 elderly women with cesarean section and postpartum hemorrhage in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected as the study group.And 420 elderly women who underwent cesarean section and did not have bleeding were selected as the control group, which may cause postoperative bleeding.Factors were analyzed and multivariate logistic regression analysis was performed on the factors that caused significant effects. Results The incidence of pregnancy hypertension, abortion history, uterine atony, macrosomia and placenta previa in the observation group was significantly higher than that in the control group (t=4.118-83.345, P=0.000-0.042). There were no statistically significant differences in gestational diabetes mellitus, postpartum hemorrhage, coagulation function and depression between the two groups(t=0.006-0.788, P=0.375-0.938). Multivariate logistic regression analysis showed that gestational hypertension, history of abortion, uterine atony, macrosomia and placenta previa were risk factors for postpartum hemorrhage in elderly parturients after cesarean section (OR=2.114-19.521, P=0.035-0.001). Conclusion Pregnancy-induced hypertension, history of abortion, uterine atony, macrosomia and placenta previa are the main factors affecting postpartum hemorrhage in elderly women with cesarean section.This provides an effective basis for the nursing of cesarean section postpartum hemorrhage in elderly women. Key words: Postpartum hemorrhage; Cesarean section; Hypertension, pregnancy-induced; Abortion, induced; Uterine inertia; Placenta previa; Fetal macrosomia; Risk factors

The Optimal Cutoff Level of D-Dimer during Pregnancy to Exclude Deep Vein Thrombosis, and the Association between D-Dimer and Postpartum Hemorrhage in Cesarean Section Patients.

The main purpose was to clarify the optimal D-dimer cutoff level during pregnancy to exclude deep vein thrombosis (DVT) prior to Cesarean section. The secondary purpose was to determine whether D-dimer can predict severe postpartum hemorrhage (PPH) in Cesarean section patients. Two hundred and seventy eight elective Cesarean section cases were enrolled. Clinical factors and blood parameters at 34-37 weeks of gestation were analyzed. To detect DVT, lower extremities veins were examined using color Doppler ultrasonography in cases with D-dimer level ≥ 1.5 μg/mL. In addition, postpartum blood loss amounts during Cesarean section were recorded. Five DVT cases occurred in 250 singleton pregnancies, and 2 DVT cases occurred in 28 twin pregnancies. The overall incidence of DVT was 2.5%. The D-dimer level was higher in DVT cases than in non-DVT cases (3.84±1.97 vs. 2.31±1.48 μg/mL, P<0.01). The optimal D-dimer cutoff level was 2.6 μg/mL with a negative predic tive value of 99.5%, and sensitivity of 85.7%. PPH during Cesarean section was positively correlated with D-dimer level in all pregnancies. However, this relationship disappeared after excluding twin pregnancies. A D-dimer level < 2.6 μg/mL at 34-37 weeks of gestation has the potential to exclude DVT. D-dimer can be an independent predictor for severe PPH for all Cesarean section cases, including twin pregnancies.

Effect of uterine compression suture in the prevention and treatment of postpartum hemorrhage of cesarean section

Objective To analyze the clinical effect of uterine artery ligation combined with modified uterine compression suture in the prevention and treatment of postpartum hemorrhage. Methods A total of 107 patients with refractory cesarean section who were treated with uterine artery ligation combined with modified uterine compression suture were selected as treatment group.Of the patients treated with conventional treatment, 83 patients were included in the control group.The effective hemostasis rate, clinical curative effect, incision infection, postpartum hemorrhage, blood transfusion rate, mattress rate and postoperative morbidity were compared between the two groups. Results The amount of intraoperative blood loss (1 106±458.78)mL in the treatment group was significantly higher than (753.6±302.30)mL in the control group, the difference was statistically significant (t=1.892, P 0.05). The transfusion rate in the treatment group was 27.10%, which in the control group was higher than 10.84%, the difference was statistically significant between the two groups (χ2=7.722, P 0.05). The incision infection rate and postoperative morbidity rate were 0.00% in the treatment group and the control group, and the two groups were treated with Ⅱ / A healing. Conclusion Uterine artery ligation combined with improved uterine compression suture in the prevention and treatment of postpartum hemorrhage has good hemostasis effect, hysterectomy rate is low, it is worthy of promoting and application. Key words: Medical care; Postpartum hemorrhage; Uterine artery ligation; Uterine compression suture

A comparative study on infusion of usual dose of oxytocin and 80 units dose of oxytocin in the prevention of postpartum hemorrhage in cesarean section.

Postpartum hemorrhage is one of the main causes of mothers’ death mostly in developing country. The frequency of postpartum hemorrhage after natural pregnancy and cesarean are reported 2%–4% and 6%, respectively. The main goal of this study is to compare two regimens of oxytocine: One with high dose and the other with normal one to prevent uterine atony. The study has been done via a clinical trial method on 150 pregnant women in Zahedan, Iran. The society is randomly divided into two groups. The patients having risk factors of uterine atony and postpartum hemorrhage were omitted from the list. Oxytocin with 80 and 30 dose was, respectively, infused in 500 cc Ringer serum for control and witness group immediately after infant emersion during a period of 30 min. Decline of hemoglobin 6 and 24 h after cesarean section, uterine atony, blood infusion, and extra uterotonic drug needs after oxytocin infusion have been measured for both groups. The data have been analyzed using Chi-square via SPSS software. The result indicates that there exist meaningful differences between control and witness group in uterine atony and extra utertonic drug need while and after surgery (0 as compared with 22.6% and P = 0); whereas there is no significant difference between control and trial group in decline of hemoglobin 6 and 24 h after cesarean section (P = 0.714 and 0.231, respectively). It means that oxytocin infusion with 80 dose has a good impact on the above four variances. It is recommended that oxytocin infusion with 80 dose during a period of 30 min could be a good substitution for oxytocin infusion with 30 dose for the prevention of uterine atony during and after cesarean delivery, especially when utertonic drug is not accessible and in the case of counterindication of other drugs’ use.

Methamphetamine, smoking, and gestational hypertension affect norepinephrine levels in umbilical cord tissues

Background: These studies were undertaken to determine methamphetamine (METH) and smoking effects on umbilical vascular dynamics and pregnancy outcomes. Materials and Methods: Umbilical cords (54) were collected prospectively at birth, washed of blood, and stored at -80°C. Cords were thawed and lysates prepared, then catecholamine levels quantified with enzyme-linked immunosorbent assay (ELISA). Results: Catecholamine levels in umbilical cords were not associated with maternal or gestational age, gravidity, parity, neonatal or placental weight. Neither smoking nor METH affected dopamine or epinephrine. However, smoking (two-fold) and METH (four-fold) decreased norepinephrine and together a 60-fold reduction occurred (p = 0.025). Cesarean section and hypertension were both associated with lower norepinephrine levels (p Discussion: Depletion of norephinephrine by METH and smoking likely contributes to pregnancy complications, including the higher incidence of respiratory distress and postpartum hemorrhage in cesarean section.

Effect of evidence-based nursing on obstetrics childbirth

Objective To compare the effects of evidence based nursing and simple accompanying nursing mode in obstetrics childbirth.Methods A total of 428 cases of pregnant women were taken as the research objects , of which , from 2011 May to 2012 March a-dopted a simple accompanying nursing mode on 228 cases （control group）, from 2012 April to 2013 June, 200 cases of maternal adopt evi-dence-based nursing （observation group）, maternal labor time and delivery address were compared between two groups .Results after nursing, the observation group the first stage of labor , the second stage of labor and the third stage of labor respectively were significantly lower than those of the control group （ P<0.05 ） .In the observation group the natural childbirth parturient 24 hours postpartum bleeding a-mount was 3.33%, significantly lower than that of the control group （ P〈0.05 ） , and in the observation group cesarean section postpartum hemorrhage 24 hours the incidence of more than 500 ml was 7.50%, and the incidence of it in the control group was 9.86%（ P〉0.05 ） .Conclusions Compared with simple accompanying nursing measures , evidence-based nursing has the more important status in the obstet-ric delivery, which can effectively shorten the delivery process , increase the rate of vaginal delivery and reduce the rate of cesarean section and it is worthy of clinical application. Key words: Evidence-based nursing; Simple accompanying nursing mode of delivery; Obstetric delivery

Clinical Analysis of 186 Cases of Postpartum Hemorrhage after Cesarean Section

&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this paper, we analyzed retrospectively 186 cases of postpartum hemorrhage in our hospital, and analyzed the characteristics and clinical analysis of postpartum hemorrhage in cesarean section. &lt;strong&gt;Method: &lt;/strong&gt;Pregnant women were selected from March 2010 to March 2014 in our hospital. The causes of postpartum hemorrhage and postpartum hemorrhage were compared with natural labor and cesarean section. &lt;strong&gt;Results&lt;/strong&gt;&lt;strong&gt;: &lt;/strong&gt;In 4622 pregnant women, 2631 cases are cesarean section while 1991 cases are vaginal delivery. There were 268 cases of postpartum hemorrhage, including 82 cases of postpartum vaginal bleeding, 186 cases of postpartum hemorrhage after cesarean section. The incidence of postpartum hemorrhage was 7.07%, and the rate vaginal birth postpartum hemorrhage was 4.11%, and there was significant difference between them (&lt;em&gt;p&lt;/em&gt; &amp;lt; 0.01). Uterine inertia is two kinds of mode of delivery to the main causes of postpartum hemorrhage, followed by rupture of the soft birth canal and placental factors etc. &lt;strong&gt;Conclusion: &lt;/strong&gt;Cesarean section is the cause of postpartum hemorrhage. It was found that pregnant women postpartum hemorrhage should actively take treatment to ensure the safety of pregnant women in perinatal period.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Clinical Analysis of 186 Cases of Postpartum Hemorrhage after Cesarean Section

Objective: In this paper, we analyzed retrospectively 186 cases of postpartum hemorrhage in our hospital, and analyzed the characteristics and clinical analysis of postpartum hemorrhage in cesarean section. Method: Pregnant women were selected from March 2010 to March 2014 in our hospital. The causes of postpartum hemorrhage and postpartum hemorrhage were compared with natural labor and cesarean section. Results : In 4622 pregnant women, 2631 cases are cesarean section while 1991 cases are vaginal delivery. There were 268 cases of postpartum hemorrhage, including 82 cases of postpartum vaginal bleeding, 186 cases of postpartum hemorrhage after cesarean section. The incidence of postpartum hemorrhage was 7.07%, and the rate vaginal birth postpartum hemorrhage was 4.11%, and there was significant difference between them ( p < 0.01). Uterine inertia is two kinds of mode of delivery to the main causes of postpartum hemorrhage, followed by rupture of the soft birth canal and placental factors etc. Conclusion: Cesarean section is the cause of postpartum hemorrhage. It was found that pregnant women postpartum hemorrhage should actively take treatment to ensure the safety of pregnant women in perinatal period.

Logistic regression analysis of risk factors of postpartum hemorrhage of cesarean section

Objective To investigate the risk actors of postpartum hemorrhage of cesarean section,in order to provide the basis for the prevention of hemorrhage after cesarean section.Methods A case-control study was conducted in 100 cases with postpartum hemorrhage of cesarean section and 200 cases without bleeding of cesarean section.The clinical data were compared and analyzed.The single factor and multiple factors of the Logistic analysis was used to analyze the risk factors of postpartum hemorrhage of cesarean section.Results Fetal macrosomia (OR =3.678,95％ CI:1.456-5.345),placenta adhesion (OR =4.264,95％ CI:1.556-5.646),placenta praevia (OR =2.754,95％ CI:1.754-5.456),multifetal pregnancy (OR =3.964,95％ CI:1.274-4.453) were the risk factors of postpartum hemorrhage after cesarean section.Conclusion Evaluation of the above risk factors before cesarean section was important for prevention of postpartum hemorrhage. Key words: Postpartum hemorrhage; Cesarean section; Logistic regression

Clinical study on misoprostol with combined calcium in the treatment of postpartum hemorrhage of cesarean section

Objective To investigate the misoprostol and calcium combined treatment of postpartum hemorrhage of cesarean section clinical curative effect.Methods The subjects were cesarean section 68 cases of pregnant women,which were randomly divided into the observation group and the control group,34 cases in each group,the control group at 600 micrograms misoprostol,observed in this group based on the use of calcium(before skin incision slow intravenous push 50％ GS 20 ml + 10％ calcium gluconate 10 ml),observe two groups of intraoperative,postpartum 2 hours and 24 hours postpartum hemorrhage volume.Results In the observation group,intraoperative blood loss[(188.47 + 13.29) vs(385.24±14.16 ml)]was significantly less than that of the control group,2 hours postpartum bleeding volume[(133.56±11.45) vs(219.4±12.73) ml]was significantly less than that of the control group,24 hours postpartum bleeding volume[(171.29±21.91) vs(257.36±33.42) ml]was also significantly less than that of the control group,the difference was statistically significant(t =1.982,1.895,1.714,all P ＜0.05).Conclusion Misoprostol and calcium combined treatment can significantly reduce postpartum hemorrhage of casarean section on maternal and child safety,security,worthy of clinical application. Key words: Misoprostol; Calcium; Cesarean section; Postpartum hemorrhage

Clinical analysis of 68 cases with improved B-Lynch suture for postpartum hemorrhage of cesarean section

Objective To observe the clinical efficacy of improved B-Lynch suture in the treatment of postpartum hemorrhage of cesarean section caused by uterine inertia.Methods There were 98 cases of postpartum hemorrhage during cesarean section from 2006.1 to 2009.12.68 cases of postpartum hemorrhage of cesarean section treated with B-Lynch suture served as the study group.30 cases of parturient patients treated with tradition technique for postpartum hemorrhage of cesarean section were recruited as control group.Operation time,hemorrhage volume,puerperal morbidity and therapeutic efficacy between the two groups were compared.Results All cases in the study group were effectively stanched with preservation of uterine and no postoperative complication was found.The differences were significant for operation time,hemorrhage volume,puerperal morbidity and success rate between the study group and the control group( P ＜0.05).There was no hysterectomy in study group satisfac tory clinical results.Conclusion Improved B-Lynch suture technique is useful for its simplicity of application,life saving potential,relative safety and capacity for preserving the uterus and subsequent fertility.It is an effective treatment for postpartum hemorrhage during cesarean section. Key words: Cesarean section; Postpartum hemorrhage; Improved B-Lynch suture technique