Postpartum hemorrhage after vaginal birth : An analysis of risk factors

• Published in: Southern medical journal (Birmingham, Ala.) Vol. 98; no. 4; pp. 419 - 422
• Main Authors: MAGANN, Everett F, EVANS, Sharon, HUTCHINSON, Maureen, COLLINS, Robyn, HOWARD, Bobby C, MORRISON, John C
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.04.2005; Southern Medical Association
• Subjects: Adolescent; Adult; Biological and medical sciences; Childbirth; Delivery, Obstetric - methods; European Continental Ancestry Group; Female; General aspects; Hemorrhage; Humans; Medical sciences; Middle Aged; Postpartum Hemorrhage - etiology; Pregnancy; Pregnancy Complications, Hematologic; Risk Factors; Vagina; Medicine; Factor analysis; Risk factor; Vagina; Risk analysis; Birth; Puerperium; Hemorrhage
• ISSN: 0038-4348; 1541-8243
• DOI: 10.1097/01.SMJ.0000152760.34443.86

To determine, in a single tertiary obstetric hospital, the incidence of and risk factors for postpartum hemorrhage (PPH) after a vaginal birth. PPH was defined as measured blood loss greater than 1,000 mL and/or need for a transfusion. Over a 4-year period, 13,868 of 19,476 women delivered vaginally, with a PPH rate of 5.15%. Identified risk factors for PPH were Asian race, maternal blood disorders, prior PPH, history of retained placenta, multiple pregnancy, antepartum hemorrhage, genital tract lacerations, macrosomia (>4 kg), and induction of labor, as well as chorioamnionitis, intrapartum hemorrhage, still birth, compound fetal presentation, epidural anesthesia, prolonged first/second stage of labor, and forceps delivery after a failed vacuum. Identification of risk factors for PPH after a vaginal delivery may afford prophylactic treatment of such women with reduction of morbidity.