Investigation of Treatment Measures for Severe Postpartum Hemorrhage Relat-ed to Massive Transfusion:a Multi-center Retrospective Study
10.3969/j.issn.1003-6946.2025.10.011
- VernacularTitle:多中心严重产后出血大量输血救治措施情况调查
- Author:
Qun ZHANG
1
;
Ning GU
1
;
Jing FANG
1
;
Yan ZHOU
1
;
Yimin DAI
1
Author Information
1. 南京大学医学院附属鼓楼医院妇产科,江苏南京 210008
- Publication Type:Journal Article
- Keywords:
Severe postpartum hemorrhage;
Massive transfusion;
Uterotonic agents;
Intrauterine packing;
Hysterectomy
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(10):831-835
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the use of treatment measures in patients with severe postpartum hemor-rhage and massive blood transfusion.Methods:A retrospective analysis was conducted on the clinical data of parturients from 18 medical institutions who gave birth between January 2019 and June 2023,with postpartum hemorrhage≥ 1000 ml within 24 hours after delivery and red blood cell(RBC)transfusion≥4 U.According to the amount of RBC transfusion,the patients were divided into massive-transfusion(MT)group(≥ 10 U)and non-massive-transfusion(non-MT)group(4-＜10 U).The high-risk factors for postpartum hemorrhage,causes of hemorrhage,and medical and surgical treatment measures were compared between the two groups.Results:A total of 575 patients were included(134 cases in MT group and 441 cases in non-MT group).In the MT group,the proportions of multiparous women,gravidity≥2,preterm birth,previous cesarean section,placenta previa,and placenta accreta were significantly higher than those in the non-MT group,with statistically significant differences(P＜0.05).The primary cause of postpartum haemorrhage in the MT group was placental factors(58.2％),whereas uterine atony was the main cause in the non-MT group(52.2％).Analysis of medication treatment showed that carboprost tromethamine was the most frequently used secondary uterotonic in both groups(73.1％and 80.5％).Surgical management analysis revealed that the proportion of surgical interventions was higher in the MT group than that in the non-MT group.Among the 44 patients who underwent hysterectomy,33 cases un-derwent hysterectomy during cesarean section,with the primary cause of postpartum haemorrhage being placen-tal factors(29 cases,87.9％).Conclusion:Patients with severe postpartum haemorrhage requiring massive transfusion need extensive pharmacological and surgical interventions.It is crucial to reduce risk factors,particu-larly by decreasing the incidence of primary cesarean sections,optimize uterotonic use,and ultimately minimize the occurrence of severe postpartum haemorrhage and massive transfusion.
