Postpartum hemorrhage after vaginal birth: an analysis of risk factors.
OBJECTIVE
To determine, in a single tertiary obstetric hospital, the incidence of and risk factors for postpartum hemorrhage (PPH) after a vaginal birth.


METHODS
PPH was defined as measured blood loss greater than 1,000 mL and/or need for a transfusion.


RESULTS
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.


CONCLUSIONS
Identification of risk factors for PPH after a vaginal delivery may afford prophylactic treatment of such women with reduction of morbidity.
Magann
Everett F
EF
School of Women and Infants Health, King Edward Memorial Hospital, Perth, Australia.
Evans
Sharon
S
Hutchinson
Maureen
M
Collins
Robyn
R
Howard
Bobby C
BC
Morrison
John C
JC
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D012307:Risk Factors; D044465:White People