Margaret Flood1, Susan J McDonald2, Wendy Pollock2,3,4, Fiona Cullinane5, Mary-Ann Davey6. 1. Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia. 2. School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia. 3. Maternal Critical Care, Melbourne, Victoria, Australia. 4. Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia. 5. Maternity Services, Royal Women's Hospital, Melbourne, Victoria, Australia. 6. Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Increasing incidence and severity of postpartum haemorrhage, together with postpartum haemorrhage-associated morbidities, have been reported in many high-resource countries. In-depth analysis of such factors in Victorian births since 2002 was lacking. AIMS: Our aim was to determine the incidence and trends for primary postpartum haemorrhage (World Health Organization and International Classification of Diseases 10th revision, Australian Modification definitions) for all confinements in Victoria, Australia, for the years 2003-2013 and the incidence and trends for severe postpartum haemorrhage (≥1500 mL) for 2009-2013. MATERIALS AND METHODS: In this population-based cross-sectional study de-identified data from the Victorian Perinatal Data Collection were analysed for confinements (excluding terminations) from 2003 to 2013 (n = 764 244). Perinatal information for all births ≥20 weeks (or of at least 400 g birthweight if gestation was unknown) were prospectively collected. RESULTS: One in five women (21.8%) who gave birth between 2009 and 2013 experienced a primary postpartum haemorrhage and one in 71 women (1.4%) experienced a severe primary postpartum haemorrhage. The increasing trends in incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage, blood transfusion, admission to an intensive care or high dependency unit and peripartum hysterectomy were significant (P < 0.001). Women who had an unassisted vaginal birth had the lowest incidence of primary postpartum haemorrhage. The highest incidence was experienced by women who had an unplanned caesarean section birth. Women who had a forceps birth had the highest incidence of severe primary postpartum haemorrhage. CONCLUSIONS: The incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage and associated maternal morbidities have increased significantly over time in Victoria.
BACKGROUND: Increasing incidence and severity of postpartum haemorrhage, together with postpartum haemorrhage-associated morbidities, have been reported in many high-resource countries. In-depth analysis of such factors in Victorian births since 2002 was lacking. AIMS: Our aim was to determine the incidence and trends for primary postpartum haemorrhage (World Health Organization and International Classification of Diseases 10th revision, Australian Modification definitions) for all confinements in Victoria, Australia, for the years 2003-2013 and the incidence and trends for severe postpartum haemorrhage (≥1500 mL) for 2009-2013. MATERIALS AND METHODS: In this population-based cross-sectional study de-identified data from the Victorian Perinatal Data Collection were analysed for confinements (excluding terminations) from 2003 to 2013 (n = 764 244). Perinatal information for all births ≥20 weeks (or of at least 400 g birthweight if gestation was unknown) were prospectively collected. RESULTS: One in five women (21.8%) who gave birth between 2009 and 2013 experienced a primary postpartum haemorrhage and one in 71 women (1.4%) experienced a severe primary postpartum haemorrhage. The increasing trends in incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage, blood transfusion, admission to an intensive care or high dependency unit and peripartum hysterectomy were significant (P < 0.001). Women who had an unassisted vaginal birth had the lowest incidence of primary postpartum haemorrhage. The highest incidence was experienced by women who had an unplanned caesarean section birth. Women who had a forceps birth had the highest incidence of severe primary postpartum haemorrhage. CONCLUSIONS: The incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage and associated maternal morbidities have increased significantly over time in Victoria.
Authors: Victoria Brazil; Darren McLean; Belinda Lowe; Lada Kordich; Deborah Cullen; Victoria De Araujo; Talia Eldridge; Eve Purdy Journal: BMC Health Serv Res Date: 2022-09-01 Impact factor: 2.908
Authors: Pim B B Schol; Natascha M de Lange; Mallory D Woiski; Josje Langenveld; Luc J M Smits; Martine M Wassen; Yvonne M Henskens; Hubertina C J Scheepers Journal: PLoS One Date: 2021-06-25 Impact factor: 3.240
Authors: Sarah F Bell; Adam Watkins; Miriam John; Elinore Macgillivray; Thomas L Kitchen; Donna James; Cerys Scarr; Christopher M Bailey; Kevin P Kelly; Kathryn James; Jenna L Stevens; Tracey Edey; Rachel E Collis; Peter W Collins Journal: BMC Pregnancy Childbirth Date: 2020-05-06 Impact factor: 3.007