OBJECTIVE: To determine the risk of occurrence and recurrence of postpartum haemorrhage (excessive bleeding after childbirth) among women having at least two consecutive pregnancies. DESIGN AND SETTING: Population-based study using longitudinally linked hospital discharge and birth records from New South Wales for the period 1 January 1994 to 31 December 2002. PARTICIPANTS: All 125,295 women having at least a first and second pregnancy resulting in a singleton birth at > 400 g or > or = 20 weeks' gestation in the study period. MAIN OUTCOME MEASURES: Risk of occurrence of postpartum haemorrhage (PPH) in any pregnancy, and of recurrence of PPH in subsequent (second and third) pregnancies. RESULTS: 5.8% of women (7327/125,295) had a PPH in their first pregnancy, and 4.5% (5318/117,968) had a first PPH in their second pregnancy. Among the 23,095 women who had three pregnancies in the study period, 4.4% (908/20,839) had a first PPH in their third pregnancy. The risk of recurrence in a second consecutive pregnancy was 14.8% (1082/7327), and in a third consecutive pregnancy (after two previous PPHs) was 21.7% (43/198); even with an intervening pregnancy with no PPH (ie, PPH in the first and third pregnancies only), the risk for the third pregnancy was 10.2% (111/1085). CONCLUSIONS: These consistently elevated risks of recurrence highlight the need for women with a history of PPH to have active management of the third stage of labour and to give birth in a hospital that has onsite blood cross-match facilities.
OBJECTIVE: To determine the risk of occurrence and recurrence of postpartum haemorrhage (excessive bleeding after childbirth) among women having at least two consecutive pregnancies. DESIGN AND SETTING: Population-based study using longitudinally linked hospital discharge and birth records from New South Wales for the period 1 January 1994 to 31 December 2002. PARTICIPANTS: All 125,295 women having at least a first and second pregnancy resulting in a singleton birth at > 400 g or > or = 20 weeks' gestation in the study period. MAIN OUTCOME MEASURES: Risk of occurrence of postpartum haemorrhage (PPH) in any pregnancy, and of recurrence of PPH in subsequent (second and third) pregnancies. RESULTS: 5.8% of women (7327/125,295) had a PPH in their first pregnancy, and 4.5% (5318/117,968) had a first PPH in their second pregnancy. Among the 23,095 women who had three pregnancies in the study period, 4.4% (908/20,839) had a first PPH in their third pregnancy. The risk of recurrence in a second consecutive pregnancy was 14.8% (1082/7327), and in a third consecutive pregnancy (after two previous PPHs) was 21.7% (43/198); even with an intervening pregnancy with no PPH (ie, PPH in the first and third pregnancies only), the risk for the third pregnancy was 10.2% (111/1085). CONCLUSIONS: These consistently elevated risks of recurrence highlight the need for women with a history of PPH to have active management of the third stage of labour and to give birth in a hospital that has onsite blood cross-match facilities.
Authors: Anna Sara Oberg; Sonia Hernandez-Diaz; Kristin Palmsten; Catarina Almqvist; Brian T Bateman Journal: Am J Obstet Gynecol Date: 2013-10-26 Impact factor: 8.661
Authors: Marian Knight; William M Callaghan; Cynthia Berg; Sophie Alexander; Marie-Helene Bouvier-Colle; Jane B Ford; K S Joseph; Gwyneth Lewis; Robert M Liston; Christine L Roberts; Jeremy Oats; James Walker Journal: BMC Pregnancy Childbirth Date: 2009-11-27 Impact factor: 3.007
Authors: A Briley; P T Seed; G Tydeman; H Ballard; M Waterstone; J Sandall; L Poston; R M Tribe; S Bewley Journal: BJOG Date: 2014-02-12 Impact factor: 6.531