INTRODUCTION: Postpartum hemorrhage is responsible for 25% of maternal pregnancy-related deaths and it is the first cause of maternal morbidity and mortality worldwide. OBJECTIVE: To define the prevalence of postpartum hemorrhage and associated risk factors after vaginal birth and to develop a risk model that improves postpartum hemorrhage prediction. PATIENTS AND METHODS: All women who underwent a vaginal delivery at the Obstetric Unit of a large University hospital in Milan (Italy) between July 2007 and September 2009 were enrolled. Postpartum hemorrhage was defined as ≥ 500 mL blood loss. A nomogram tailored to predict postpartum hemorrhage was developed, summarizing the impact of each covariate on the probability of postpartum hemorrhage. RESULTS: 6011 women were studied (24% had blood loss ≥ 500 mL and 4.8% ≥ 1000 mL). Nulliparity, episiotomy, retained placenta and high neonatal body weight were confirmed as risk factors for postpartum hemorrhage. The odds ratio of postpartum hemorrhage was 0.86 (95%CI 0.78-0.90) for each 1 gr/dL increase in ante-partum hemoglobin. An extensive internal validation of the developed nomogram demonstrated a good stability of the risk model. CONCLUSIONS: Low ante-partum hemoglobin is a new potentially modifiable risk factor for postpartum hemorrhage. A nomogram to predict the probability of postpartum hemorrhage is now available for external validation. Copyright Â
INTRODUCTION: Postpartum hemorrhage is responsible for 25% of maternal pregnancy-related deaths and it is the first cause of maternal morbidity and mortality worldwide. OBJECTIVE: To define the prevalence of postpartum hemorrhage and associated risk factors after vaginal birth and to develop a risk model that improves postpartum hemorrhage prediction. PATIENTS AND METHODS: All women who underwent a vaginal delivery at the Obstetric Unit of a large University hospital in Milan (Italy) between July 2007 and September 2009 were enrolled. Postpartum hemorrhage was defined as ≥ 500 mL blood loss. A nomogram tailored to predict postpartum hemorrhage was developed, summarizing the impact of each covariate on the probability of postpartum hemorrhage. RESULTS: 6011 women were studied (24% had blood loss ≥ 500 mL and 4.8% ≥ 1000 mL). Nulliparity, episiotomy, retained placenta and high neonatal body weight were confirmed as risk factors for postpartum hemorrhage. The odds ratio of postpartum hemorrhage was 0.86 (95%CI 0.78-0.90) for each 1 gr/dL increase in ante-partum hemoglobin. An extensive internal validation of the developed nomogram demonstrated a good stability of the risk model. CONCLUSIONS: Low ante-partum hemoglobin is a new potentially modifiable risk factor for postpartum hemorrhage. A nomogram to predict the probability of postpartum hemorrhage is now available for external validation. Copyright Â
Authors: Elise Farrington; Mairead Connolly; Laura Phung; Alyce N Wilson; Liz Comrie-Thomson; Meghan A Bohren; Caroline S E Homer; Joshua P Vogel Journal: Reprod Health Date: 2021-05-18 Impact factor: 3.223
Authors: Kartik K Venkatesh; Robert A Strauss; Chad A Grotegut; R Philip Heine; Nancy C Chescheir; Jeffrey S A Stringer; David M Stamilio; Katherine M Menard; J Eric Jelovsek Journal: Obstet Gynecol Date: 2020-04 Impact factor: 7.623
Authors: Babette W Prick; Joost F von Schmidt Auf Altenstadt; Chantal W P M Hukkelhoven; Gouke J Bonsel; Eric A P Steegers; Ben W Mol; Joke M Schutte; Kitty W M Bloemenkamp; Johannes J Duvekot Journal: BMC Pregnancy Childbirth Date: 2015-02-21 Impact factor: 3.007
Authors: Kastriot Dallaku; Haleema Shakur; Phil Edwards; Danielle Beaumont; Ian Roberts; Sumaya Huque; Maria Delius; Ulrich Mansmann Journal: Wellcome Open Res Date: 2016-12-15
Authors: Ada Gillissen; Thomas van den Akker; Camila Caram-Deelder; Dacia D C A Henriquez; Sebastiaan W A Nij Bijvank; Kitty W M Bloemenkamp; Jeroen Eikenboom; Johanna G van der Bom Journal: Res Pract Thromb Haemost Date: 2019-04-04
Authors: Wobke E M van Dijk; Jelle S Nijdam; Saskia Haitjema; Mark C H de Groot; Albert Huisman; Marieke C Punt; Annemiek C C Evers; Roger E G Schutgens; A Titia Lely; Karin P M van Galen Journal: J Thromb Haemost Date: 2021-08-20 Impact factor: 16.036