Medline ® Abstract for Reference 95
of 'Normal and abnormal labor progression'
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Postpartum hemorrhage following vaginal delivery: risk factors and maternal outcomes.
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Miller CM, Cohn S, Akdagli S, Carvalho B, Blumenfeld YJ, Butwick AJ
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J Perinatol. 2017;37(3):243.
OBJECTIVE:
Limited understanding of risk factors exists for postpartum hemorrhage (PPH) post-vaginal delivery. The aim of this study was to identify risk factors for PPH post-vaginal delivery within a contemporary obstetric cohort.
STUDY DESIGN:
Retrospective case-control study. PPH was classified by an estimated blood loss⩾500 ml. Risk factors for PPH were identified using univariable and multivariable logistic regression. We secondarily investigated maternal outcomes and medical and surgical interventions for PPH management.
RESULTS:
The study cohort comprised 159 cases and 318 controls. Compared with a second-stage duration<2 h, a second stage⩾3 h was associated with PPH (adjusted odds ratio=2.3; 95% CI=1.2 to 4.6). No other clinical or obstetric variables were identified as independent risk factors for PPH. Among cases, 4% received red blood cells and 1% required intensive care admission.
CONCLUSION:
Although PPH-related morbidity may be uncommon after vaginal delivery, PPH should be anticipated for women after a second stage⩾3 h.
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Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
PMID