The Perinatal Research Consortium (PRC): A Re-evaluation of Traditional Post-Partum Hemorrhage (PPH) Risk Factors

Objective: - To analyze the risk factors for primary post partum Haemorrhage. Settings: - Gynae/Obstetrics-Unit I Lady Willingdon Hospital Lahore. Study Design: - Observational Analytical study. Duration: - One year Ist January 2005 to 31 December 2005. Materials/Methods:-It was an observational analytical study in which the data about patients was collected with the help of proformas. Conclusion:- Uterine atony due to various underlying risk factors is the major cause of post partum Haemorrhage. If these factors are identified and treated accordingly then a lot of mothers can be saved.

Download Full-text

ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS.

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2014.069 ◽

2014 ◽

Vol 6 (1) ◽

pp. e2014069 ◽

Cited By ~ 7

Author(s):

Luciana Teofili ◽

Maria Bianchi ◽

Bruno A Zanfini ◽

Stefano Catarci ◽

Rossella Sicuranza ◽

...

Keyword(s):

Risk Factors ◽

Acute Lung Injury ◽

Lung Injury ◽

Gestational Hypertension ◽

Post Partum ◽

Univariate Analysis ◽

High Risk Population ◽

Post Partum Hemorrhage ◽

Hypertensive Disorders ◽

Clinical Records

Background. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without fresh frozen plasma (FFP) and platelet (PLT) transfusion. Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia within 6 hours after transfusion, with bilateral pulmonary changes in the absence of cardiogenic pulmonary edema were identified as TRALI; if an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed.Results. Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer post-partum hospitalization. Among several pregnancy-related diseases (including hypertensive disorders, anemia, intrahepatic cholestasis, gestational diabetes) and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis, including both transfusion- and patient-related risk factors, pregnancy-related hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27-604.3, p=0.034).Conclusions. Patients suffering from PPH represent a high-risk population for TRALI. In particular, patients with gestational hypertension and pre-eclampsia have the highest risk, particularly if they are not receiving anti-hypertensive therapy. A careful monitoring of these patients after transfusions is therefore recommended.

Download Full-text

Risk factors for post-partum hemorrhage following vacuum assisted vaginal delivery

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-016-4208-5 ◽

2016 ◽

Vol 295 (1) ◽

pp. 75-80 ◽

Cited By ~ 5

Author(s):

Liran Hiersch ◽

Riki Bergel-Bson ◽

Dorit Asher ◽

Amir Aviram ◽

Rinat Gabby-Benziv ◽

...

Keyword(s):

Risk Factors ◽

Vaginal Delivery ◽

Post Partum ◽

Assisted Vaginal Delivery ◽

Post Partum Hemorrhage

Download Full-text

Risk factors for post-partum hemorrhage in patients who underwent operative vaginal delivery in a tertiary care center

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20214066 ◽

2021 ◽

Author(s):

Gayatri Devi Sivasambu ◽

Sujani B. Kempaiah ◽

Urvashi Thukral

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Vaginal Delivery ◽

Post Partum ◽

Tertiary Care ◽

Significant Risk ◽

Post Partum Hemorrhage ◽

Second Stage ◽

Operative Vaginal Delivery ◽

Vaginal Deliveries

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.

Download Full-text

Post-partum Hemorrhage and Anemia as its Modifiable Risk Factor: A Literature Review

Jurnal Keperawatan Soedirman ◽

10.20884/1.jks.2019.14.3.1205 ◽

2019 ◽

Vol 14 (3) ◽

Author(s):

Mekar Dwi Anggraeni ◽

Rahmi Setiyani ◽

Nina Setiawati

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Maternal Mortality ◽

Postpartum Hemorrhage ◽

Post Partum ◽

Multiple Pregnancy ◽

Modifiable Risk Factor ◽

Post Partum Hemorrhage ◽

History Of ◽

Develop Strategy

<p>Maternal mortality is an indicator of a country’s health status. Postpartum hemorrhage is the main cause of maternal mortality. Understanding the postpartum hemorrhage risk factors useful to develop strategy in order to reduce maternal mortality. The aim of this study was to find modifiable postpartum hemorrhage's risk factors. This study used 6 steps which include formulating the research questions and objectives, searching the extant literature, screening for inclusion, assessing the quality of primary studies, extracting data, and analyzing data. The article was searched from Google Scholar and NCBI databases using bilingual keywords: "faktor-faktor, perdarahan postpartum, risk factors, and postpartum hemorrhage". There were 1736 papers founded and only 14 articles met the inclusion criteria and included in the analysis. The review revealed that anemia, age, parity, birth passage laceration, obstetric history, multiple pregnancy, placental retention, prolonged labor, atonia uteri, pre-eclampsia, pregnancy induced hypertension, section caesarian, placental complication, history of post-partum hemorrhage, episiotomy, high neonatal birth weight. Anemia is the only modifiable risk factor which may be prevented by nurses. </p>

Download Full-text