• Atalay Ekin, Cenk Gezer, Ulas Solmaz, Cuneyt Eftal Taner, Askin Dogan, and Mehmet Ozeren.
• Department of Perinatology, Tepecik Training and Research Hospital, Izmir, Turkey. atalayekin@hotmail.com.
• Arch. Gynecol. Obstet. 2015 Dec 1; 292 (6): 1247-54.

PurposeTo identify risk factors and etiologies leading to severe primary postpartum hemorrhage (PPH) in women with PPH.MethodsWomen who experienced PPH within the first 24 h after delivery over a 3-year period were retrospectively evaluated. Patients were divided into two groups on the basis of severe PPH (n = 125) or non-severe PPH (n = 411). Risk factors and etiologies for severe PPH were explored using univariate and multivariate logistic regression analyses.ResultsPPH and severe PPH complicated 2.1 and 0.49 % of all deliveries, respectively. Previous cesarean delivery (OR = 3.15, 95 % CI = 1.02-10.3; p = 0.001), prolonged labor (OR = 3.62, 95 % CI = 3.21-4.03; p < 0.001), oxytocin augmentation (OR = 3.32, 95 % CI 2.05-5.93; p < 0.001) and emergency cesarean delivery (OR = 4.75, 95 % CI 1.32-12.96; p < 0.001) were the factors independently associated with severe PPH. Etiologies significantly associated with severe PPH are uterine atony (OR = 2.72, 95 % CI 1.64-4.55; p < 0.001) and abnormal placentation (OR = 3.05, 95 % CI 1.56-6.27; p = 0.006).ConclusionPrevious cesarean delivery, prolonged labor, oxytocin augmentation and emergency cesarean delivery are strongest predictors of severe blood loss in women with PPH. In addition, uterine atony and abnormal placentation are the etiologies significantly associated with severe PPH.

35 keywords...

hide…