Prevalence and risk factors of severe postpartum hemorrhage
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Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. According to researchers maternal age <18 years, previous cesarean section, history of PPH, conception through IVF, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placental abruption, PAS, and macrosomia are risk factors.

To determine the prevalence and risk factors of SPPH, doctors analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China.

In this study, they conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation. SPPH was defined as an estimated blood loss ≥1000 mL and total blood transfusion ≥4 units. Logistic regression analysis was used to identify independent risk factors for SPPH.

--SPPH was observed in 532 mothers among the total population of 34,178 mothers.

--Placenta-related problems were the major identified causes of SPPH, while uterine atony without associated retention of placental tissues accounted for 38.91%.

--The risk factors for SPPH were maternal age <18 years, previous cesarean section, history of postpartum hemorrhage, conception through in vitro fertilization, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placenta abruption, placenta accrete spectrum, and macrosomia.

In particular, extra vigilance during the antenatal and peripartum periods is needed to identify women who have risk factors and enable early intervention to prevent SPPH.

BMC Pregnancy and Childbirth
Source: https://doi.org/10.1186/s12884-021-03818-1
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