According to reports, on February 21, a first-born woman in Fuzhou, Jiangxi Province, unfortunately died during childbirth, and the initial diagnosis was amniotic fluid embolism, and the baby girl's vital signs were stable.
Among the causes of maternal death in the mainland, postpartum haemorrhage accounts for about 30%, ranking first. Hypertensive diseases in pregnancy, pregnancy complicated by heart disease, and amniotic fluid embolism each accounted for 9%-10%, ranking second to fourth, in no particular order.
NO.01
Postpartum bleeding
The amount of maternal vaginal bleeding exceeding 500 ml within 24 hours after fetal delivery is called postpartum hemorrhage, and the incidence accounts for 2%-3% of the total number of deliveries, and the actual incidence is higher due to the subjective factors of measuring and collecting the amount of bleeding.
After a woman gives birth, the placenta is peeled off, and the blood is stopped by uterine contractions. Postpartum haemorrhage may occur if the uterus contracts are weak, or if there is a retention, adhesions, or residual membranes in the placenta, or there are soft birth canal lacerations, or there is coagulation dysfunction. If timely measures are not taken to quickly stop the bleeding and replenish the blood volume, the mother will soon lose too much blood and shock, causing organ failure and death.
NO.02
Hypertension during pregnancy
Hypertensive diseases in pregnancy are a group of diseases in which hypertension, proteinuria, and edema occur during pregnancy, with an incidence rate of 9.4% in mainland China, mostly in pregnant women over 40 years of age.
The disease will cause spasm of small blood vessels throughout the pregnant woman's body, and the blood flow of various systems and organs will be reduced, resulting in cerebral ischemia or bleeding, abnormal liver function, impaired heart function and even failure, and in severe cases, death will occur. In addition, the placenta will also be ischemic and hypoxic, resulting in slow fetal growth, fetal distress and even fetal death intrauterine, neonatal death and so on.
NO.03
Pregnancy with heart disease
The incidence of pregnancy complicated by heart disease is about 1%, the uterus is enlarged during pregnancy, the blood volume increases, the burden on the heart is increased, the uterus and the whole body skeletal muscle contraction during childbirth makes a large amount of blood rush to the heart, and the postpartum circulating blood volume increases, which are easy to cause heart failure, malignant arrhythmia, pulmonary hypertension crisis, cardiogenic shock and other serious conditions that endanger the life of the mother. At the same time, due to long-term chronic hypoxia, it can lead to intrauterine dysplasia and fetal distress.
NO.04
Amniotic fluid embolism
Amniotic fluid embolism refers to the sudden entry of amniotic fluid into the maternal circulatory system during childbirth, causing acute pulmonary embolism, anaphylactic shock, disseminated intravascular coagulation, renal failure, or sudden death of serious intrapartum complications. Once amniotic fluid embolism occurs, the maternal mortality rate is very high, and even some doctors believe that as long as amniotic fluid embolism occurs, women will almost never escape death.
The specific cause of the disease is unknown, but it usually has the following precipitating factors: mostly transvasive women, a history of premature rupture of membranes or artificial rupture of membranes, common contractions or improper use of oxytocin, early detachment of the placenta, placenta previa, and rupture of the uterus or surgical delivery.
Amniotic fluid embolism occurs rapidly, often before rescue, and dies quickly within minutes, so early diagnosis is extremely important.
Seeing this, some people may develop fear and resistance to pregnancy and childbirth. In fact, expectant mothers don't have to worry too much. After the full liberalization of the two-child policy, although the proportion of elderly and high-risk mothers has increased, the maternal mortality rate on the mainland has not increased. Statistics from the National Health and Family Planning Commission in February 2017 show that the national maternal mortality rate has dropped to 19.9 per 100,000 in 2016.