title: [Frequency, causes and risk factors of postpartum haemorrhage: a population-based study in 106 French maternity units].
abstract: OBJECTIVE
  To estimate the incidence, to describe the aetiology and to identify the risk factors of postpartum haemorrhage (PPH).
  
  
  METHODS
  Prospective study conducted in 106 French maternity units of six perinatal networks between December 2004 and November 2006. PPH was defined by a blood loss superior to 500 mL or necessitating an examination of the uterus, or a peripartum haemoglobin drop superior to 2 g/dL. Severe PPH was defined by at least one of these criteria : peripartum haemoglobin drop superior or equal to 4 g/dL, embolization, conservative surgical procedure, hysterectomy, transfusion, transfer to intensive care or death.
  
  
  RESULTS
  The incidence of PPH was 6.4% [CI 95% 6.3-6.5] with variations between maternity units from 1.5% to 22.0%; incidence of severe PPH was 1.7% [CI 95% 1.6-1.8] with variations between units from 0% to 4%. Atony was the main aetiology of PPH, whatever the mode of delivery and severity. The risk factors identified were those classically described in the literature.
  
  
  CONCLUSIONS
  In these six French perinatal networks, in 2005-2006, the PPH profile was characterized by an incidence of severe forms higher than previous population-based estimates from other countries. This suggests a more frequent aggravation of PPH and the implication of inadequate PPH management.
authors.affiliation: Réseau périnatal Aurore, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; EAM 4128, laboratoire « Santé, Individu, Société », faculté de médecine Laënnec, 69372 Lyon, France. Electronic address: corinne.dupont@chu-lyon.fr.
authors.forename: C
authors.initials: C
authors.lastname: Dupont
authors.affiliation: Réseau périnatal Aurore, hôpital de la Croix-Rousse, hospices civils de Lyon, 69004 Lyon, France; EAM 4128, laboratoire « Santé, Individu, Société », faculté de médecine Laënnec, 69372 Lyon, France; Université Lyon Est, 69008 Lyon, France.
authors.forename: R-C
authors.initials: RC
authors.lastname: Rudigoz
authors.affiliation: Université de Lyon 1, 69100 Villeurbanne, France; CNRS, UMR 5558, laboratoire de biométrie et biologie évolutive, équipe biostatistique-santé, 69100 Villeurbanne, France.
authors.forename: M
authors.initials: M
authors.lastname: Cortet
authors.affiliation: Pôle d'information médicale évaluation recherche, hospices civils de Lyon, université Lyon 1, 69424 Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Touzet
authors.affiliation: EAM 4128, laboratoire « Santé, Individu, Société », faculté de médecine Laënnec, 69372 Lyon, France; Pôle d'information médicale évaluation recherche, hospices civils de Lyon, université Lyon 1, 69424 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Colin
authors.affiliation: CNRS, UMR 5558, laboratoire de biométrie et biologie évolutive, équipe biostatistique-santé, 69100 Villeurbanne, France.
authors.forename: M
authors.initials: M
authors.lastname: Rabilloud
authors.affiliation: Réseau périnatal de la région Centre, CHU de Tours, 37044 Tours, France.
authors.forename: J
authors.initials: J
authors.lastname: Lansac
authors.affiliation: Réseau périnatal de Port Royal St Vincent de Paul, 75014 Paris, France.
authors.forename: T
authors.initials: T
authors.lastname: Harvey
authors.affiliation: Réseau périnatal de Port Royal St Vincent de Paul, 75014 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Tessier
authors.affiliation: Réseau périnatal Loire Nord Ardèche, CHU de Saint-Étienne, 42100 Saint-Étienne, France.
authors.forename: C
authors.initials: C
authors.lastname: Chauleur
authors.affiliation: Réseau périnatal des 2 Savoie, centre hospitalier de Chambéry, 73011 Chambéry, France.
authors.forename: G
authors.initials: G
authors.lastname: Pennehouat
authors.affiliation: Réseau périnatal Alpes Isère, CHU de Grenoble, 38700 Grenoble, France.
authors.forename: X
authors.initials: X
authors.lastname: Morin
authors.affiliation: Inserm UMR S953 recherche épidémiologique en santé périnatale, santé des femmes et des enfants, UPMC Paris 6, 75014 Paris, France.
authors.forename: M-H
authors.initials: MH
authors.lastname: Bouvier-Colle
authors.affiliation: Inserm UMR S953 recherche épidémiologique en santé périnatale, santé des femmes et des enfants, UPMC Paris 6, 75014 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Deneux-Tharaux
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Aetiology; Facteurs de risque; Hémorragie du post-partum; Incidence; Postpartum haemorrhage; Risk factors; Étiologie