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ORIGINAL ARTICLE SMJ Article View this issue
PostpartumHemorrhageAfter
CesareanDelivery:AnAnalysisof
RiskFactors
Everett F. Magann, MD, Sharon Evans, PHD, DOI: 10.1097/01.SMJ.0000163309.53317.B8 681-685
Maureen Hutchinson, RN, RM, Robyn Collins,
RN, RM, BAPPSC, CHC, Grainger Lanneau, MD, Volume: 98 Issue: 7 July, 2005
John C. Morrison, MD
DISCUSS SDC
Abstract:
Objective:Todeterminetheincidenceandriskfactorsforpostpartum
hemorrhage(PPH)associatedwithcesareandelivery.
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Methods:Bloodlossatcesareandeliverywasmeasuredanddefinedas1,000
to1,499mLorgreaterthan1,500mLand/ortheneedforablood
transfusion.Variableswereidentifiedandevaluatedtodeterminethefactors
associatedwithPPH.
Results:Therewere1,844electiveand2,993nonelectivecesareandeliveries
over4years.ThePPHrateinnonelectivecesarean(6.75%)wasgreaterthan
afterelectivecesarean(4.84%,P=0.007).RiskfactorsforPPHafteran
electiveoperationincludedleiomyomata,blooddisorders,placentaprevia,
antepartumbleeding,pretermbirth,andgeneralanesthesia.Nonelective
cesareanPPHriskfactorsincludedblooddisorders,retainedplacenta,
antepartumtransfusion,antepartum/intrapartumhemorrhage,placenta
previa,generalanesthesia,andmacrosomia(oddsratio>1.5,confidence
interval>1.5).
Conclusions:NonelectivecesareandeliverieshaveahigherriskofPPHthan
womendeliveredelectively.Riskfactoridentificationandpreventionshould
beapriority.
KeyPoints
*Thepostpartumhemorrhage(PPH)rateinnonelectiveabdominalbirth
(6.75%)isgreaterthanafterelectivecesarean(4.84%,P=0.007).
*IdentifiedriskfactorsforPPHafteranelectiveoperationincluded
leiomyomata,placentaprevia,antepartumbleeding,pretermbirth,and
generalanesthesia.
*NonelectivecesareanPPHriskfactorsincludeblooddisorders,retained
placenta,antepartumtransfusion,antepartum/intrapartumhemorrhage,
placentaprevia,generalanesthesia,andmacrosomia.
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Article - Southern Medical Association 12/2/15, 10:01 AM
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