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

Abstract

(Birth. 2015;42(3):235–241) Immediate postpartum hemorrhage is a common and dangerous complication for which risk factors have been established. However, there is a distinct lack of research regarding secondary postpartum hemorrhage, with only 2 studies reporting on possible risk factors. These studies found a variety of risk factors, including immediate postpartum hemorrhage, hemorrhage during pregnancy, manual removal of the placenta, a history of secondary postpartum hemorrhage, hospitalization during the third trimester, maternal smoking, and a prolonged or incomplete third stage of labor. The authors of this study sought to determine what factors might indicate an increased risk for severe secondary postpartum hemorrhage with the primary goal being to determine the association with immediate postpartum hemorrhage.

Secondary Postpartum Haemorrhage: Causes and Management In A Tertiary Care Hospital

“…As in our study, frequency of secondary postpartum hemorrhage in women was observed in 20 Asian countries reported prevalence of secondary postpartum hemorrhage ranging from 11% (India) 13 to 39% (Sri Lanka) 14 32% in Nigeria 15 While in developed countries Boyd et al 16 and Iraha Y 17 et al reported 0.2% of deliveries and other studies reported rates ranging from 1% -2%. 18,19 the variation is reported frequency in developing countries could be explained in part as the majority of patients were found to be non-booked, had not received antenatal care and were delivered by un-skilled persons who might not have actively managed the third stage of labour leading to retained placenta and membrane in turn causing sepsis and further aggravating the maternal condition.…”

“…While the result of a Nigerian study by Ijaiya MA et al 21 showed mothers suffering from PPH are usually of age 35 years. Multiparity was commonly observed in our study whereas study by Debost A 20 and Ijaiya MA 21 reported majority of grand multiparous women with secondary postpartum haemorrhage.…”