Clinical Characteristics of Postpartum Women With Hypoxia: A Retrospective Analysis of 92 Cases.

Abstract

Purpose: Postpartum hypoxia is a significant concern among clinicians due to its association with fatal diseases such as amniotic fluid embolism. This study analyzed the clinical characteristics of patients with different etiologies of postpartum hypoxia.

Patients and methods: Ninety-two postpartum cases with hypoxia, defined as oxygen saturation (SpO₂) < 95% within 48 h postpartum without supplemental oxygen inhalation, and 100 normal gravidas were enrolled. All patients with postpartum hypoxia underwent 24 h vital sign monitoring and relevant examinations, including hematological tests, chest computed tomography (CT) scans, or CT pulmonary angiography, to determine the cause of hypoxia and received appropriate treatments. All patients were followed up for 1 month.

Results: Compared with normal gravidas, the patients with postpartum hypoxia had a higher occurrence rate of complications, including gestational hypertension (26.09% vs 8.00%), eclampsia (20.65% vs 4.00%), and a lower level of albumin (29.09 ± 0.57 vs 32.74 ± 0.94), thus tended to have longer hospitalization days (7.98 ± 0.40 vs 4.90 ± 0.16), with all P < 0.05. In all 92 cases, the most common cause of postpartum hypoxia was partial atelectasis with pleural effusion (65/92), followed by pulmonary edema (18/92), pneumonia (9/92), pulmonary embolism (6/92), and asthma (4/92). Among the five groups, patients with pneumonia had the longest hospital stay, whereas most patients with partial atelectasis accompanied by pleural effusion were asymptomatic. From the 1-month follow-up, all patients had a favorable prognosis with no apparent symptoms. Among those who underwent re-examination (27/92), no apparent imaging abnormalities were detected.

Conclusion: Postpartum hypoxia, which occurs more commonly in patients with gestational hypertension, is often caused by partial atelectasis with pleural effusion or pulmonary edema. The patient's prognosis was generally satisfactory after treatment.