Risk factors for primary postpartum haemorrhage

Abstract

The objective of the study was to determine which background factors predispose women to primary postpartum haemorrhage (PPH) at the Obafemi Awolowo University Hospital. The study consisted of 101 women who developed PPH after a normal vaginal delivery and 107 women with normal unassisted vaginal delivery without PPH Both cases and controls were investigated for sociodemographic risk factors, medical and obstetric histories, antenatal events and labour and delivery outcomes. Data were abstracted from the medical and delivery records and risks were estimated by multivariate logistic regression. The results of the univariate analysis revealed a number of potential risk factors for PPH but after adjustment by logistic regression three factors remained significant. These were prolonged second and third stages of labour and non-use of oxytocics after vaginal delivery. Previously hypothesised risk factors for PPH such as grand multiparity, primigravidity and previous episodes of PPH were not significantly associated with PPH. We conclude that primary PPH in this population is mostly associated with prolonged second and third stages of labour and non use of oxytocics. Efforts to reduce the incidence of PPH should not only be directed at proper management of labour but also training and retraining of primary health care workers and alternative health care providers in the early referral of patients with prolonged labour.

Oral misoprostol for preventing postpartum haemorrhage in home births in rural Bangladesh: how effective is it?

“…Consistent with prior studies (30, 31), we found similar risk factors responsible for the primary PPH. However, counts of risk were lower among women in the intervention group indicating that women were more aware about PPH and its risk factors and took necessary precautions accordingly.…”

Pharmacotherapy of Massive Obstetric Bleedings as Alternative to Hysterectomy

“…Cases of failure of pharmacological correction of bleeding with rFVIIa can be attributed to resistance, for various reasons, of the blood coagulation system to activation of redundant quantity of factor VIIa (Franchini et al, 2007;Selo-Ojeme & Okonofua, 1997;Shander et al,2005;Sobieszczyk & Breborowicz, 2004), as well as by the presence of organ dysfunction, which led to adverse outcome in 6 out of 11 women (54.5%) in our observations.…”

A Prospective Study To Evaluate The Etiology & Continuum of Management Protocol of Postpartum Haemorrhage

“…9 But Babinszki et al showed in their study that incidence of PPH was higher in grand multiparas while Selo-Ojeme and Tsu reported that there is no association between parity and PPH. [10][11] Seventy six cases (56.2%) belonged to lower middle socio-economic status followed by middle socioeconomic status 40 cases (29.6%). Bibi et al showed in their study that patients with lower socio-economic status had more frequency of PPH compared to upper socio-economic status.…”