Factors associated with early postpartum hemorrhage of singleton pregnancy in Maharat Nakhon Ratchasima Hospital

Abstract

Objective:        To determine the factors associated with early postpartum hemorrhage(PPH) of singleton pregnancy who delivered in Maharat Nakhon Ratchasima Hospital.

Materials and methods:     A cross-sectional, descriptive case-control study was design. One thousand nine hundred and fifty medical records of singleton pregnancies in Maharat Nakhon Ratchasima Hospital during 1 January 2007 to 31 December 2009 were reviewed. Cases: controls were matched 1:4. The collected data were analyzed to determine the factors associated with early PPH by univariated analysis and multiple logistic regression analysis.

Results:           There were 390 pregnancies with early PPH, and 1,560 pregnancies without early PPH. The significant factors associated with early PPH were tear of birth canal [Odds ratio(OR) 138.44, 95 %CI 59.32-323.07], coagulopathy (OR 82, 95 %CI 7.06-951.58), retained placenta (OR 47.08, 95 %CI 26.44-83.82), placenta previa (OR 31.76, 95 %CI 15.73-64.11), placental abruption (OR 7.59, 95 %CI 1.85-30.97), prolonged second stage of labor (OR 4.67, 95 %CI 1.79-12.17), intrapartum terbutaline use (OR 4.11, 95 %CI 1.02-16.49), history of dilatation & curettage (OR 3.98, 95 %CI 1.49-10.62). Only one factor, Bachelor’s degree education (OR 0.45, 95 %CI 0.2-0.95) was protective factor to early PPH.

Conclusion:    Regarding to the strategic care and management to decrease early PPH, special care and awareness should be focused on the pregnant women with history of abnormal placentation, having factors predisposing to uterine atony, coagulopathy and patients with tear of birth canal.