Abstract:

Objective To investigate how to improve quality and safety management for the department of obstetrics via comparing pregnant and delivery outcomes in multiparas before and after the implementation of  “the second child” policy.  Methods The data on the second child from the department of obstetrics at a hospital between January 2013 and June 2015 were collected and statistically analyzed. Results Since the implementation of “the second child” policy, the pregnant rate in multiparas and women with scar uterus increased. The ratio of women of advanced reproductive age, incidence rates of gestational hypertension (GH) and gestational diabetes mellitus (GDM), and rates of premature delivery, macrosomia, low birth weight delivery, and postpartum hemorrhage increased significantly. For GH multiparas, risks of neonatal asphyxia, premature delivery, low birth weight delivery, and postpartum hemorrhage increased. For GDM multiparas, risks of premature delivery, macrosomia, and low birth weight delivery increased. Conclusion Currently among women who has given birth to the second child, those of advanced reproductive age and with scar uterus, GH, and GDM increase. Poor delivery outcomes also increase. It is necessary to enhance pre-pregnancy examinations for women who wish to give birth again, prevent pregnancy complications, and improve contingency management for severe obstetric hemorrhages and hysterorrhexis, so as to ensure the safety for mothers and babies.

Key words: multipara, gestational hypertension； gestational diabetes mellitus； management