Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (4): 409-414.doi: 10.3969/j.issn.1674-8115.2022.04.002

• High-risk pregnancy column • Previous Articles     Next Articles

Analysis of risk factors of hysterectomy caused by intractable postpartum hemorrhage

HU Jianing1(), ZHANG Jinwen1, LIU Xiaorui1, CHEN Cailian2, LIN Yi1()   

  1. 1.Central Laboratory of The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Embryo Original Diseases; Institute of Birth Defects and Rare Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
    2.Department of Automation, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University; Key Laboratory of System Control and Information Processing, Ministry of Education, Shanghai 200240, China
  • Received:2021-11-18 Accepted:2022-01-10 Online:2022-04-28 Published:2022-04-28
  • Contact: LIN Yi;
  • Supported by:
    National Key R&D Program of China(2018YFC1002800);National Natural Science Foundation of China(82171669);Shanghai Jiao Tong University Trans-Med Awards Research (Major Project)(20210201)

Abstract: Objective

·To investigate the risk factors and related preventive measures of intractable postpartum hemorrhage which leads to emergency peripartum hysterectomy.


·The clinical data of 110 934 pregnant women treated in the International Peace Maternal & Child Health Hospital, Shanghai Jiao Tong University School of Medicine from January 2014 to December 2020 were analyzed retrospectively. According to the treated time, pregnant women in the 2015?2017 year-period (n=48 984) and 2018?2020 year-period (n=45 262) were selected as the research objects to analyze the incidence of emergency peripartum hysterectomy. Besides, a total of 108 pregnant women with intractable postpartum hemorrhage were selected as the research objects. The patients were divided into the uterine-removed group (n=22) and the uterine-preserved group (n=86) according to whether they had hysterectomy. The clinical data of the two groups were compared and analyzed by univariate analysis and multivariate Logistic regression model, and the risk factors of emergency peripartum hysterectomy were explored.


·Compared with the 2015?2017 year-period, the incidence of emergency peripartum hysterectomy decreased in the 2018?2020 year-period (P=0.039). Meanwhile, compared with the uterine-preserved group, the pregnant women in the uterine-removed group were older, with more than 2 pregnancies, monocyesis, pregnancy complications (placenta previa, placenta implantation, scarred uterus, etc.), amniotic fluid embolism and greater postpartum hemorrhage (all P<0.05). Multivariate Logistic regression analysis showed that the patients' age and the volume of postpartum hemorrhage were independent risk factors for emergency peripartum hysterectomy caused by intractable postpartum hemorrhage (P<0.05).


·The older the patients with intractable postpartum hemorrhage, the greater volume of postpartum hemorrhage, which is easy to lead to emergency peripartum hysterectomy. Clinical monitoring and intervention should be carried out as soon as possible to reduce the patients' incidence of emergency peripartum hysterectomy.

Key words: intractable postpartum hemorrhage, emergency peripartum hysterectomy, clinical characteristics

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