Selection of Obstetric Hemorrhagic Shock Resuscitation Protocol and Its Impact on Shock Correction Time and Complications

YU Hong; GAO Huiguang; PEI lipeng; LIU lina

doi:10.13919/j.issn.2095-6274.ZHJY202505067

Abstract：Objective To explore the clinical characteristics of obstetric hemorrhagic shock and compare the clinical outcomes of combined resuscitation protocols with traditional resuscitation protocols.Methods A retrospective analysis was conducted on the clinical data of 82 obstetric hemorrhagic shock patients treated in the Department of Obstetrics and Gynecology at the 970th Hospital of the Joint Logistics Support Force,Weihai Med-ical Area,from January 2018 to January 2025.Based on the resuscitation protocol,patients were divided into the observation group(combined resuscitation protocol,41 patients)and the control group(traditional resuscitation protocol,41 patients).Clinical symptoms and signs,causes of hemorrhagic shock,and shock severity distri-bution were recorded.The shock correction time,total hospital stay,incidence of complications,rate of hys-terectomy,and mortality were compared between the two groups.Multivariate linear regression analysis was performed to identify factors affecting shock correction time.Results Among the 82 obstetric hemorrhagic shock patients,the majority(46.34％)had moderate shock(38 cases).The shock correction time(P＜0.001)and hospital stay(P＜0.001)were significantly shorter in the observa-tion group compared to the control group.Multivariate linear regression analysis showed that the shock correction time in the observation group was significantly shorter than in the control group(P=0.016).The correction time for moderate shock was longer than for mild shock(β=0.537,P=0.046),and the correction time for severe shock was even longer(β=1.103,P=0.019).Vaginal delivery was associated with a significantly longer shock correction time compared to cesarean section(β=0.892,P=0.009).Uterine atony was associated with a shorter shock correction time(β=-0.318,P=0.011),while placental factors significantly prolonged the correction time(β=0.211,P=0.029).The incidence of complications in the observation group was 17.07％,significantly lower than 36.59％in the control group(P＜0.05).No statistically significant differences were observed between the two groups in terms of hysterec-tomy rate(9.76％vs.14.63％,P＞0.05)and mortality rate(0.00％vs.2.44％,P＞0.05).Conclusion The combined resuscitation protocol is significantly superior to the traditional protocol,effectively shortening the shock correction time and hospital stay,with a lower incidence of complications.Multivariate linear regression analysis indicates that moderate and severe shock,vaginal delivery,uterine atony,and placental factors significantly influence shock correction time.Early identification of high-risk factors and multidisciplinary collaboration are key to improving the success rate of treatment.