Risk factors for postpartum hemorrhage ACOG
|
Practice Guideline Show
. 2017 Oct;130(4):e168-e186. doi: 10.1097/AOG.0000000000002351. Collaborators
Practice Guideline Practice Bulletin No. 183: Postpartum HemorrhageCommittee on Practice Bulletins-Obstetrics. Obstet Gynecol. 2017 Oct. AbstractMaternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). In the United States, the rate of postpartum hemorrhage increased 26% between 1994 and 2006 primarily because of increased rates of atony (3). In contrast, maternal mortality from postpartum obstetric hemorrhage has decreased since the late 1980s and accounted for slightly more than 10% of maternal mortalities (approximately 1.7 deaths per 100,000 live births) in 2009 (2, 4). This observed decrease in mortality is associated with increasing rates of transfusion and peripartum hysterectomy (2-4).The purpose of this Practice Bulletin is to discuss the risk factors for postpartum hemorrhage as well as its evaluation, prevention, and management. In addition, this document will encourage obstetrician-gynecologists and other obstetric care providers to play key roles in implementing standardized bundles of care (eg, policies, guidelines, and algorithms) for the management of postpartum hemorrhage. Similar articles
Cited by
Publication typesMeSH termsLinkOut - more resources
What are the risk factors for postpartum hemorrhage?Conditions that may increase the risk for postpartum hemorrhage include the following:. Placental abruption. The early detachment of the placenta from the uterus.. Placenta previa. ... . Overdistended uterus. ... . Multiple pregnancy. ... . Gestational hypertension or preeclampsia. ... . Having many previous births.. Prolonged labor.. Infection.. What is the number #1 risk factor for postpartum hemorrhage?The risk factors more strongly associated and the incidence of moderate postpartum hemorrhage in women with each of these factors were: retained placenta (33.3%), multiple pregnancy (20.9%), macrosomia (18.6%), episiotomy (16.2%), and need for perineal suture (15.0%).
What are the 5 most common causes of PPH?In many International and local studies it was revealed that the main cause of PPH is uterine atony followed by vaginal hematoma, cervical or vaginal tear, adherent placenta, uterine angle extension and retained placenta [3,5].
What are the 3 main causes of postpartum hemorrhage?The Four T's mnemonic can be used to identify and address the four most common causes of postpartum hemorrhage (uterine atony [Tone]; laceration, hematoma, inversion, rupture [Trauma]; retained tissue or invasive placenta [Tissue]; and coagulopathy [Thrombin]).
|
