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Postpartum haemorrhage occurrence and recurrence: a population‐based study
Author(s) -
Ford Jane B,
Roberts Christine L,
Bell Jane C,
Algert Charles S,
Morris Jonathan M
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb01308.x
Subject(s) - medicine , postpartum haemorrhage , obstetrics , pregnancy , biology , genetics
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 > 400g 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.