Prevalence and risk factors affecting early postpartum hemorrhage among vaginal delivery at Burapha University Hospital

Abstract

Abstract
Context: Early postpartum hemorrhage is the leading cause of maternal deaths, accounting for 27% of all maternal deaths worldwide. The prevalence of deaths from early postpartum hemorrhage in Thailand during 2009-2015 was 2.30%, 2.37%, 2.44%, 2.40%, 2.39%, 2.54% and 2.65%, respectively. Prevalence studies and risk factors for vaginal postpartum hemorrhage vary across regions in Thailand and the results of the research can be used as a guideline for caring for pregnant women.
Objective: To study the prevalence, risk factors and causes of early postpartum hemorrhage within the first 24 hours among vaginal deliveries at Burapha University Hospital, as well as to identify factors related to the among of early postpartum hemorrhage.
Materials and methods: A retrospective descriptive study was conducted between January 1, 2015 and December 31, 2020. The population comprised of all 2,569 pregnant women who gave birth at Burapha University Hospital. The following inclusion criteria 1) vaginal delivery, and 2) blood loss ≥ 500 ml. within 24 hours after delivery, thus 94 participants were included in the study.
Results: The prevalence of early postpartum hemorrhage among vaginal deliveries was 6.14%, of minor postpartum hemorrhage was 4.51%, and of major postpartum hemorrhage was 1.63%. The principle causes of hemorrhage were vaginal laceration (47.9%), and uterine atony (21.3%). Factors associated with increased risk for postpartum hemorrhage were age (p < .05). and prolonged stage of intrapartum (p < .01).
Conclusion: The prevalence of early postpartum hemorrhage among women who had vaginal birth at Burapha University Hospital, was higher than that reported nationally. The most common causes of postpartum hemorrhage were genital tract laceration and uterine atony. Factors associated with the amount of early postpartum hemorrhage were age, duration of intrapartum period and cause of hemorrhage. The findings would inform the development of care practices to prevent early postpartum hemorrhage in order to reduce maternal mortality.