Analysis of the Clinical Features of Critical Obstetric Cases After the "Two-Child Policy" was Fully Implemented

Abstract Objective: To analyse the changes in the clinical features of critical obstetric cases after the "two-child policy" was fully implemented. Study Design: Retrospective analysis was used. Results: In the study group, the percentage of pregnant women who were older (35~40 years (27.8% vs 26.8%), over 40 years (8.6% vs 5.7%)), and multipara (67.8% vs 47.8%). The major diagnoses for intensive care unit transfer were postpartum haemorrhage. In the two groups, the prevalence of WHO near-miss criteria critical scores was 83.5% vs 76.6%. ICU hospitalization time (2.8 days vs 4 days) and total hospitalization time (12 days vs 15 days). In the study group, the number cases with blood loss below 3000 ml was higher than that in the control group (47.3% vs 30.6%). The number of cases with blood transfusion volume greater than 2000 ml was lower than that in the control group (39.8% vs 60.5%). Postpartum haemorrhage was mainly due to placental previa/placental implantation and was significantly increased in the study group (61.6% vs. 44.2%,), and the prevalence was higher in individuals who underwent hysterectomy (31.5% vs. 24.2%). Conclusion: Under the new policy, the epidemiological characteristics of critical obstetric cases should be considered, and the effective critical care score should take into account not only the utilization rate, turnover rate and length of stay in the ICU but also the economic benefits, planned blood use, length of stay and cost of stay to minimize the incidence of critical cases and reduce maternal mortality.