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1: South Med J. 2005 Apr;98(4):419-22. Links

Postpartum hemorrhage after vaginal birth: an analysis of risk factors.

Magann EF, Evans S, Hutchinson M, Collins R, Howard BC, Morrison JC.

School of Women and Infants Health, King Edward Memorial Hospital, Perth, Australia.

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.

PMID: 15898516 [PubMed - indexed for MEDLINE]