Objective:Analyze the causes and risk factors of postpartum hemorrhage since the Two-child poli-cy was carried out,raise the awareness and probe into the measures of prevention and cure.Methods:Retrospective-ly analyzed the data of 60 cases of postpartum hemorrhage.Results:The total incidence of postpartum hemorrhage was 1.4%;the incidence of postpartum hemorrhage by vaginal delivery was 0.6%;and the incidence of postpartum hemorrhage by the lower uterine cesarean section was 2.4%,comparing these two results,the difference was signif-icant (P＜ 0.5).Among them,the cesarean section featured by "the previous cesarean section" accounted for 14. 6% of all deliveries,it also accounted for 32.6% of the total number of cesarean sections.Uterine atony still re-mains the primary cause of postpartum hemorrhage,followed by placental adhesions and placental implantation that are the most common causes of postpartum hemorrhage.What’s more,among the postpartum hemorrhage pa-tients,there is no significant effect on the amount of postpartum hemorrhage caused by complications and accompan-ying diseases of gestation period.Conclusion:Uterine atony still remains the primary cause of postpartum hemor-rhage,and placenta adhesion and implantation are the second leading cause.With the continuous improvements of maternal health care technology and obstetric quality,obstetric lacerations and coagulation defects have been rare. With the Two-child policy goes into effect,the proportion of pregnant women who have previously had a history of cesarean section increased significantly and become a high-risk group for cesarean section postpartum hemorrhage. However,postpartum hemorrhage still occurred in some women who weren’t recognized as group of obvious high-risk factors in their first births,it is suggested that all pregnant women should raise their awareness and prevent ac-tively,and get prepared to respond to postpartum hemorrhage at any time,improve maternal care to reduce the inci-dence of postpartum hemorrhage.%目的:分析二胎政策开放后产后出血的常见原因及危险因素,提高对产后出血原因及高危因素的认识并探讨防治措施.方法:对发生产后出血的60例产妇资料进行回顾性分析.结果:产后出血总的发生率为1.4%;经阴道分娩产后出血发生率为0.6%,经子宫下段剖宫产分娩产后出血发生率为2.4%,两者相比较,差异有统计学意义(P＜0.5).其中,以"前次剖宫产"为指征的剖宫产占所有分娩总数的14.6%,占所有剖宫产总数的32.6%.子宫收缩乏力仍是产后出血的首位原因,而胎盘粘连、植入成为继宫缩乏力后最常见的产后出血原因.在产后出血病人当中,妊娠期合并症及并发症对产后出血量无显著影响.结论:随着国家二胎政策开放,既往曾有剖宫产史的孕妇比例明显上升,并成为剖宫产产后出血的高危人群.但仍发现对一些初产没有明显可识别高危因素的产妇仍然发生了产后出血,提示对所有的孕妇都应提高预警,做好随时应对产后出血的准备,积极预防,降低产后出血发生率,改善产妇预后.
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