1972년 1월 1일부터 1981년 12월 31일까지 연세대학교 부속 세브란스 병원에 입원하여 1,000gm 이상의 배아를 분만한 20.811명의 산모중 산후출혈 환자 468명을 대상으로 하여 임상적으로 조사분석한 결과 다음과 같은 결론을 얻었다. 1. 산후출혈의 빈도는 2.2%였다. 2. 직접사임에 의한 모성 사망율은 생아 10,000명당 13.2였으며 출혈로 인한 모성사망율은 생아 10,000명당 2.0이었다. 3. 산후출혈의 원인은 이완성자궁출혈이 71.2%, 배반전잔유성 출혈이 11.5% 산도열상이 10.9% 그리고 혈액응고 장애로 인한 출혈이 1.7%였다. 4. 산후출혈의 소인중 다태임신, 임신중 고혈압성 질환, oxytocin사용, 그리고 4,000 gm 이상의 신생아 체중 등에서만 의의있게 산후출혈의 빈도가 높았다. 5. 자궁수축제, 수혈등을 포함한 대중요법에 의한 치료가 85.5% 수술적 치료가 14.5%였으며 평균수혈량은 이완성자궁출혈에서 2.2 unit, 산도열상에서 3.2 unit, 그리고 태반편잔유성 출혈에서는 5.2 unit였다. 6. 산후출혈에 의한 자궁적출술은 30에로 자궁적출술의 빈도는 694분만당 1에이며 대부분이 3시간 이내에 실시되었다.

Leading cause of the maternal mortality is obstetric hemorrhage. The postpartum hemorrhage is known as the most common cause of serious obstetric hemorrhage and one-fourth of the maternal death from obstetric hemorrhage is related to postpartum hemorrhage. Postpartum hemorrhage is subdivided itno two categories; immediate and delayed. Immediate postpartum hemorrhage is defined as blood loss more than 500 ml during the first 24 hours after birth of infant, and late postpartum hemorrhage as that occuring beyond 24 hours and extending up to 6 weeks postpartum. In recent years, even though the maternal mortality rate has been reduced dramatically by improvement of medicine, obstetric care and hospitalization for delivery, death from hemorrhage remains predominent in the most reports, and about 80% of obstetric hemorrhage, which was major cause of maternal death in the developing country was reported to have been prevented. This retrospective study was carried out for the further prevention and treatment of postpartum hemorrhage. It was based on the clihical records of 468 patients encountered at the Dept.of OB and Gyn. Yonsei University College of Medicine from Jan.1, 1972 to Dec. 31, 1981. The results obtained were as follows: 1. Over all incidence of postpartum hemorrhage was 2.2%. 2. Maternal mortality rate as direct cause of death was 13.2 per 10,000 live birth, and 2.0 per 10,000 live bith from obstetiric hemorrhage. 3. The main cause of postpartum hemorrhage was uterine atony(71.2%), retained placental tissue(11.5%), laceration of genital tract(10.9%), and coagulation defect(1.7%). 4. The significant predisposing factors related to postpartum hemorrhage are weight of baby >= 4000 gm), use of pitocin, hypertension during pregnancy and multiple pregnancy(p<0.05). 5. 400 cases(85.5%) were treated by conservative treatment with or without blood transfusion, and opeation was performed on 68 cases(14.5%). The average amount o blood transfusion was 2.2 units in uterine atony, 3.2 units in genital tract laceration, and 5.2 units in retained placental tissue. 6. 30 postpartum hysterectomies out of a total 20,811 deliveries make an incidence of 1 per 694 total birth, and three-quarter of which was performed within 3 hours after delivery.