Uterine atony risk factor after vaginal delivery in a tertiary hospital in Antananarivo, Madagascar

Ratsiatosika, Tanjona A.; Romuald, Randriamahavonjy; Lantonirina, Rainibarijaona A.; Ibrahim, Housni; Martial, Rakotonirina; Mhoudine, Said Ismael; Ando-Miora, Rakotonirina; Rakotovao, Andrianampanalinarivo H.

doi:10.18203/2320-1770.ijrcog20190310

Cited by 3 publications

(3 citation statements)

References 15 publications

(38 reference statements)

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“…Various studies state that the definition of PPH varies, but this study defines PPH based on the agreement of practitioners and experts, i.e., blood loss of 500 mL or more in vaginal delivery that occurs in the first 24 hours postpartum [3], [9]. According to a recent study based on an updated nomenclature, PPH is a cumulative blood loss of 1,000 mL or blood loss accompanied by signs and symptoms of hypovolemia which occurs within 24 hours of delivery [2].…”

Section: Resultsmentioning

confidence: 99%

“…The threshold of bleeding as indicator for PPH is ≥500 ml blood loss within 24 hours of a vaginal birth [6], The threshold is said to be the causes of PPH vary widely. Of the current recorded cases of PPH, the most common causes are uterine atony, which accounts for 70% [7] and ≥80% [8], and failure of the uterus to contract [9], including retained placenta, perineal rupture and coagulopathy [7]. Although most cases of bleeding during labor are normal, some turn out to be abnormal [10], [11].…”

Section: Introductionmentioning

confidence: 99%

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Risk identification for early warning of bleeding among mothers during childbirth

Sulastri

Siregar²,

Hasanuddin³

et al. 2023

IJPHS

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The study was conducted using the observational method. It assessed blood loss using a calibrated measuring cup every 15 minutes in the first hour after delivery and every 30 minutes for the next hour. The results of the analysis showed that the modelling of early warning identification in laboring mothers is influenced by the age and weight of the mother, which is at a significance of 10%. A major warning sign is an increase in blood pressure rate in the third stage of labor which begins 15 minutes from the start of bleeding, and is categorized as dangerous when the blood volume reaches 600 mL. Therefore, every mother in labor must be monitored regularly and continuously and early warning signs must be taken into account. There is no safe time in cases of blood loss. It is very important to identify the risks in a timely manner to identify the source of bleeding so that it can be handled quickly and appropriately in order to prevent complications and maternal death due to postpartum haemorrhage (PPH). Implication, effective and optimal identification in clinical practice should be evidence-based in order to better determine whether or not intervention is needed to prevent blood loss after childbirth.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk identification for early warning of bleeding among mothers during childbirth

Sulastri

Siregar²,

Hasanuddin³

et al. 2023

IJPHS

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“…It affects 10% of births and is responsible for 13.200 maternal deaths each year worldwide. Uterine atony is the main etiology for 80% of postpartum hemorrhage [8].…”

Section: Discussionmentioning

confidence: 99%

P₂A₀ 38-year-old Woman Postpartum Hemorrhage with Hemorrhagic Shock and Severe Anemia Caused by Uterine Atony: A Case Report from Southwest Sumba, East Nusa Tenggara

Anriani,

Harold I.M. Rumopa

2023

EJMED

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Postpartum hemorrhage is one of the most common obstetric emergencies and the largest contributor to maternal mortality in the world, with uterine atony being the most common cause. A 38-year-old woman came to Karitas Hospital complaining of vaginal bleeding after giving birth three hours ago. On examination, the patient was somnolent with signs of shock. Anemic conjunctiva, pale lips, weak contractions of the uterus, and active vaginal bleeding. The laboratory results show severe anemia and leukocytosis. The diagnosis was P2A0 38-year-old woman, postpartum spontaneously with hemorrhagic postpartum caused by uterine atony with hemorrhagic shock and severe anemia. The treatment was given according to the algorithm for managing postpartum hemorrhage. Uterine atony is caused by many factors, one of which is precipitous labor as experienced by the patient. Fluid rescucitation, uterotonics, uterine massage, bimanual compression, and the insertion of a condom catheter were given because there was still active bleeding after the 3rd stage of active management. Finally, surgical intervention should’ve been taken as the last step to stop the bleeding. Fast and precise handling can prevent complications of postpartum hemorrhage, namely shock and death.

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Determinants of postpartum uterine atony in urban South Ethiopia: a community-based unmatched nested case–control study

Jena¹,

Biks

Gete

et al. 2023

BMC Pregnancy Childbirth

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Background Uterine atony is the most common cause of postpartum hemorrhage, which is the leading preventable cause of maternal morbidity and mortality. Despite several interventions uterine atony-related postpartum hemorrhage remains a global challenge. Identifying risk factors of uterine atony helps to reduce the risk of postpartum hemorrhage and subsequent maternal death. However, evidence about risk factors of uterine atony is limited in the study areas to suggest interventions. This study aimed to assess determinants of postpartum uterine atony in urban South Ethiopia. Methods A community-based unmatched nested case–control study was conducted from a cohort of 2548 pregnant women who were followed-up until delivery. All women with postpartum uterine atony (n = 93) were taken as cases. Women who were randomly selected from those without postpartum uterine atony (n = 372) were taken as controls. Using a case to control ratio of 1:4, the total sample size was 465. An unconditional logistic regression analysis was done using R version 4.2.2 software. In the binary unconditional logistic regression model variables that have shown association at p < 0.20 were recruited for multivariable model adjustment. In the multivariable unconditional logistic regression model, statistically significant association was declared using 95% CI and p < 0.05. Adjusted odds ratio (AOR) used to measure the strength of association. Attributable fraction (AF) and population attributable fraction (PAF) were used to interpret the public health impacts of the determinants of uterine atony. Results In this study, short inter-pregnancy interval < 24 months (AOR = 2.13, 95% CI: 1.26, 3.61), prolonged labor (AOR = 2.35, 95% CI: 1.15, 4.83), and multiple birth (AOR = 3.46, 95% CI: 1.25, 9.56) were determinants of postpartum uterine atony. The findings suggest that 38%, 14%, and 6% of uterine atony in the study population was attributed to short inter-pregnancy interval, prolonged labor, and multiple birth, respectively, which could be prevented if those factors did not exist in the study population. Conclusions Postpartum uterine atony was related to mostly modifiable conditions that could be improved by increasing the utilization of maternal health services such as modern contraceptive methods, antenatal care and skilled birth attendance in the community.

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Uterine atony risk factor after vaginal delivery in a tertiary hospital in Antananarivo, Madagascar

Cited by 3 publications

References 15 publications

Risk identification for early warning of bleeding among mothers during childbirth

Risk identification for early warning of bleeding among mothers during childbirth

P₂A₀ 38-year-old Woman Postpartum Hemorrhage with Hemorrhagic Shock and Severe Anemia Caused by Uterine Atony: A Case Report from Southwest Sumba, East Nusa Tenggara

Determinants of postpartum uterine atony in urban South Ethiopia: a community-based unmatched nested case–control study

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