Objective: To study the levels and clinical significance of four items of coagulation, D-dimer, and platelet before delivery, and provide guidance for clinical diagnosis and treatment. Methods: The retrospective analysis was used to research 1 200 puerperae eastablishing a manual for perinatal health care in Affiliated Hospital of Jianghan University (Wuhan Sixth Hospital) from January 2017 to December 2019. According to postpartum hemorrhage, all puerperae were divided into a study group (postpartum hemorrhage) and a control group (normal delivery). There were 420 cases in the study group and 780 cases in the control group. We collected the test results of four coagulation items [fibrinogen (FIB), prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT)], D-dimer and platelet count in 1 200 pregnant women. And then, we also compared with and analyzed the test results of coagulation and D-dimer in early, middle, late pregnancy and diverse periods before labor. Results: D-dimer in pregnant women increased gradually, and the difference was statistically significant (P<0.05). The difference was not statistically significant in comparing the PT of late pregnancy with the early and middle pregnancy (P<0.05). The difference was not statistically significant in comparing the TT of four preiods (P>0.05). The APTT of early pregnancy was significantly longer than that in the middle, late pregnancy and before labor and the difference is statistically significant (P<0.05). The FIB of puerperae in the early, middle, late pregnancy and pre parturient increased gradually, and the difference was statistically significant (P<0.05). With the statistic significance of the differences, the PT and APTT in the study group were obviously lower than that of the control group (P<0.05), but its FIB was more than the control group (P<0.05). The difference of TT between the study group and the control group was statistically significant (P>0.05). The platelet count of the study group was much less than that of control gtoup, while its D-dimer was more than the control group, and the differences were statistically significant (P<0.05). Conclusion: The detection of four items of blood coagulation, D-dimer and platelet before delivery can facilitate the management of the abnormal blood coagulation in time, which is a very significant guidance for the pre-treatment of postpartum hemorrhage and thrombus.