Risk Factors for Primary Postpartum Hemorrhage

Abstract

Primary postpartum hemorrhage (PPH) is an important cause of maternal mortality. There are many risk factors for PPH. This case-control study aimed to identify risk factors of PPH in Naresuan University hospital.  The data were collected from pregnant women who gave labor between April 2014 to July 2017. Study  population consisted of 118 cases of postpartum hemorrhage patients and 236 controls (no postpartum  hemorrhage patients). The causes of PPH were uterine atony (45.8%), vaginal laceration (27.1%), placenta  problems (14.4%) and other causes or multiple causes (12.7%). Significance risk factors of PPH found in this  study were grand multiparity (≥ G4) (OR 2.753; 95%CI 1.209-6.272, p-value 0.013), multiple gestation (OR  6.268; 95%CI 1.245-31.548, p-value 0.019), operative obstetrics (OR 3.142;95%CI1.447-6.823, p-value 0.003), retained pieces of placenta (OR 12.142; 95%CI 2.645-55.737), placenta previa (p-value < 0.001) and prolonged  second stage of labor (OR 2.734; 95%CI 2.250-3.324, p-value 0.003). Based on our findings, pregnant women,  who has these risk factors, should be used to monitor and early manage for postpartum hemorrhage