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

Ting Wang,1 Rui Liu,1 Yuanpeng Li,2 Wei Qian,2 Man Niu2 1Department of Respiratory Medicine, Xi’an People’s Hospital (Xi’an No.4 hospital), Xi’an, 710004, People’s Republic of China; 2Department of Pathology, Xi’an People’s Hospital (Xi’an No.4 hospital), Xi’an, 710004, People’s Republic of ChinaCorrespondence: Man Niu, Department of Pathology, Xi’an People’s Hospital (Xi’an No.4 hospital), Xi’an, 710004, People’s Republic of China, Tel/Fax +86-15809182359, Email [email protected]: 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.Plain Language Summary: After giving birth, some women experience low oxygen levels, a condition known as postpartum hypoxia. This can be caused by various medical issues, such as fluid buildup in the lungs (pulmonary edema), collapsed lung areas (atelectasis), infections like pneumonia, or even blood clots in the lungs (pulmonary embolism). Detecting and treating this condition early is important to ensure the mother’s recovery.In this study, we analyzed the medical records of 92 women who developed postpartum hypoxia at a hospital in China. We compared these women to 100 healthy postpartum women to understand the causes and risk factors of this condition. The study found that the most common causes of postpartum hypoxia were partial lung collapse with fluid buildup (pleural effusion) and pulmonary edema. Many affected women also had pregnancy-related high blood pressure (gestational hypertension) or low protein levels in their blood (hypoproteinemia).Doctors treated patients based on the cause of their hypoxia. Treatments included oxygen therapy, medications to remove excess fluid, antibiotics for infections, and blood thinners for clots. Most women recovered well within a short period.This study highlights the importance of monitoring oxygen levels in postpartum women, especially those with risk factors like high blood pressure or low protein levels. The study also suggests that unnecessary imaging tests, which may expose breastfeeding infants to radiation, can sometimes be avoided with careful monitoring and treatment. More research is needed to improve guidelines for managing postpartum hypoxia.Keywords: postpartum hypoxia, partial atelectasis, pulmonary edema, prognosis