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Dryad

Data from: the characteristics and treatment for severe postpartum hemorrhage in different midwifery hospitals in one district of Beijing in China: an institution-based, retrospective cohort study

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Jan 27, 2024 version files 66.96 KB

Abstract

Objective: To identify the characteristics and treatment approaches for Severe Postpartum Hemorrhage (SPPH) patients in various midwifery institutions in one district in Beijing, especially those without identifiable antenatal PPH risk factors, to improve regional SPPH rescue capacity.

Design: Retrospective cohort study

Setting: This study was conducted at nine tertiary-level hospitals and ten secondary-level hospitals in Haidian district of Beijing from January 2019 to December 2022.

Participants: The major inclusion criterion was SPPH cases with blood loss 1500 ml or needing a packed blood product transfusion 1000 ml within 24 h after birth. A total of 324 mothers suffering from SPPH were reported to the Regional Obstetric Quality Control Office from 19 midwifery hospitals.

Outcome measures: The pregnancy characteristics collected included: age at delivery, gestational weeks at delivery, height, parity, delivery mode, antenatal PPH risks, etiology of PPH, bleeding amount, PPH complications, transfusion amount, and PPH management. SPPH characteristics were compared between two levels of midwifery hospitals and their association with antenatal PPH high-risk factors was determined.

Results: SPPH was observed in 324 mothers out of 106697 mothers in the four years. There were 74.4% and 23.9% cases of SPPH without detectable antenatal PPH high-risk factors in secondary and tertiary midwifery hospitals, respectively. Primary uterine atony was the leading cause of SPPH in secondary midwifery hospitals, whereas placental-associated disorders were the leading causes in tertiary institutions, accounting for over 50% of cases. In all SPPH cases, the rates of red blood cell transfusion over 10U, unscheduled returns to the operating room, and adverse PPH complications were higher in patients without antenatal PPH risk factors. Secondary hospitals had significantly higher rates of trauma compared with tertiary institutions.

Conclusion: Examining SPPH cases at various institutional levels offers a more comprehensive view of regional SPPH management and enhances targeted training in this area.