RISK FACTORS FOR POSTPARTUM HEMORRHAGE VIA VAGINAL DELIVERIES: SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

ABSTRACTS

BACKGROUND: Previous studies found vary and similar risk factors for postpartum hemorrhage (PPH). Meta-analysis of risk factors for PPH via vaginal deliveries from various previous studies, it will be clearly knowledge about risk factors for PPH via vaginal deliveries. 

OBJECTIVE: To analyze and identify risk factors for PPH via vaginal deliveries.

METHODS: Twenty articles related to risk factors for PPH which studied from 2005 to 2017, in Thailand and globally, were reviewed and analyzed by fixed effect technique in MedCalc Version 18.6.

RESULTS: Risk factors for PPH via vaginal deliveries found that 21 factors include: 8 high risk factors for PPH (odds ratio > 2.0) as antepartum hemoglobin ≤ 10 g/dL, coagulopathy, prior PPH, fibroid, placenta previa, placenta accrete, multiple pregnancy, and gestational hypertensive disorder; 6 moderate risk factors  for PPH (odds ratio > 1.5 – 2.0) as  nulliparous, large gestational age, placenta abruption, chorioamnionitis, induction and augmentation of labor; 7 low risk factors for PPH (odds ratio > 1.0 – 1.5) as maternal age < 19 years old and ≥ 35 years old, all BMI level, primiparous, gestational age ≥ 42 weeks, gestational diabetes mellitus, and received analgesic drugs.

CONCLUSIONS AND DISCUSSIONS: The pregnant women with antepartum hemoglobin ≤ 10 g/dL, coagulopathy, prior PPH, fibroid, placenta previa, placental accreta, multiple pregnancy, and gestational hypertensive disorder are high risk group for probability occur PPH via vaginal deliveries. Therefore, health care providers should closely monitor PPH via vaginal deliveries in this group