Risk Factors for Severe Secondary Postpartum Hemorrhages: A Historical Cohort Study

Debost‐Legrand, Anne; Rivière, Olivier; Dossou, Mathieu; Vendittelli, Françoise

doi:10.1111/birt.12175

Cited by 14 publications

(12 citation statements)

References 18 publications

(30 reference statements)

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“…This corroborates with previous studies where age more than 35 years was found to be associated with increased risk of secondary PPH. 4,15 Retained products of contraception was documented as a possible cause in maximum number of patients (72%) which is consistent with previous studies. 5,6 It signifies the role of unskilled and unhealthy delivery practices as a leading risk factor for secondary PPH.…”

Section: Discussionsupporting

confidence: 90%

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Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Nigeen

Farooq

Afzal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Postpartum haemorrhage (PPH) is a very common complication that follows delivery. It is one of the leading causes of maternal mortality both in developing and developed countries. Primary PPH has been studied a lot, but data regarding secondary PPH is sparse. Our objective was to study the clinical characteristics and outcome of patients presenting with secondary PPHMethods: A retrospective descriptive study done at Lalla Ded hospital Srinagar, a tertiary care hospital of North India, between June 2015 and December 2015.Results: Fifty patients with secondary PPH were studied out of whom 36 were delivered outside this hospital and referred. Fourteen patients who delivered in this hospital developed secondary PPH. Mean age of patients was 35±3 years. Retained products of contraception (RPOCs) was the leading cause in 36 (72%) of patients followed by endometritis in ten (20%). Mean hemoglobin concentration was 8.7±1.9grams ranging from 4.4 grams to 12.9 grams. Mean hospital stay was 6.3±1.5 days ranging from 1 day to 20 days. Curettage was done in 40 (80%) of patients including 36 having RPOC s and check curettage in four patients. Fourteen (28%) patients required blood transfusion. One patient required hysterectomy. None of the patients died.Conclusions: Secondary PPH has been studied very little. Our results show retained products of contraception as a leading cause of secondary PPH which is probably related to poor management of third stage of labour. There is crucial role of active management of third stage of labour in preventing secondary PPH. Majority of secondary PPH patients require dilatation and curettage with other supportive measures only. Surgical intervention is rarely required. Blood loss is usually mild to moderate. Prognosis is good if medical intervention is sought early.

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Section: Discussionsupporting

confidence: 90%

“…These two risk factors have been associated with secondary PPH and all steps should be taken to prevent these. 14,15 Mean age of our patients was 35±3 years. This corroborates with previous studies where age more than 35 years was found to be associated with increased risk of secondary PPH.…”

Section: Discussionmentioning

confidence: 94%

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Nigeen

Farooq

Afzal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…Maternal factors such as age, parity, health status, and obstetric conditions have been associated with increased rates of PPH. For example, research has shown that maternal age of greater than 35 years [7], and multiparous [8] are higher risks for PPH. Moreover, complications during pregnancy, such as pregnant women with diabetes mellitus [9] and pregnant women with chronic anemia [6,10] appear to also increase the risk of PPH.…”

Section: Introductionmentioning

confidence: 99%

Maternal and health service predictors of postpartum hemorrhage across 14 district, general and regional hospitals in Thailand

Prapawichar

Ratinthorn

Utriyaprasit

et al. 2020

BMC Pregnancy Childbirth

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Background: Postpartum hemorrhage (PPH) is a preventable complication, however, it remains being the leading cause of maternal mortality and morbidity worldwide including Thailand. Methods: A case-control study to examine the risk factors associated with PPH across the hospitals under the Ministry of Public Health in Thailand, was conducted. A total of 1833 patient birth records and hospital profiles including human and physical resources from 14 hospitals were obtained. A multiple logistic regression was used identifing the factors that are significantly associated with PPH. Results:The results show that the rate of PPH varied across the hospitals ranging from 1.4 to 10.6%. Women with past history of PPH were more likely to have increased risk of having PPH by 10.97 times (95% CI 2.27,53.05) compared to those who did not. The odds of PPH was higher in district and general hospitals by 14 (95% CI 3.95, 50.04) and 7 (95% CI 2.27,23.27) times respectively, compared to regional hospitals. The hospitals which had inadequate nurse midwife to patient ratio (OR 2.31,95% CI 1.08,4.92), lacked nurse midwives with working experience of 6-10 years (OR 2.35, 95% CI 1.41,3.92), as well as inadequate equipment and supplies for emergency obstetric care (OR 6.47, 95% CI 1.93,21.63), had significantly higher incidence of having PPH, respectively. Conclusions:This study provides interesting information that the rate of PPH varies across the hospitals in Thailand, in particular where essential nurse midwives, equipment, and supplies are limited. Therefore, improving health care services by allocating sufficient human and physical resources would contribute to significantly reduce this complication.

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“…We thank the authors for their interest and comments about our studies, in which we first sought to describe the global incidence of secondary postpartum hemorrhages (PPH) and the distribution of the different types of these secondary PPH (1), and then searched for potential prognostic factors of secondary PPH (2).…”

Section: Replymentioning

confidence: 99%

“…Moreover, our study populations are not comparable. Our study included only women who had had a secondary PPH, whereas that of Baba et al included only women who had an ultrasound a month after giving birth (1)(2)(3). French practice does not call for routine postpartum ultrasound examinations, but limits them to women with clinical signs who indicate the need for imaging.…”

Section: Replymentioning

confidence: 99%

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Vendittelli

Dossou

Debost‐Legrand

et al. 2016

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Risk Factors for Severe Secondary Postpartum Hemorrhages: A Historical Cohort Study

Cited by 14 publications

References 18 publications

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Maternal and health service predictors of postpartum hemorrhage across 14 district, general and regional hospitals in Thailand

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