Atonic Postpartum Hemorrhage: Blood Loss, Risk Factors, and Third Stage Management

• DOI: 10.1016/j.jogc.2016.06.014
• Publication Date: 2016-11-26T08:10:02Z
• Authors: Sarka Lisonkova; Azar Mehrabadi; Victoria M. Allen; Emmanuel Bujold; Joan M.G. Crane; Laura Gaudet; Robert J. Gratton; Noor Niyar N. Lad...; Olufemi A. Olatun...; K.S. Joseph
• Keywords: Uterotonic

Atonic postpartum hemorrhage rates have increased in many industrialized countries recent years. We examined the blood loss, risk factors, and management of third stage labour associated with atonic hemorrhage. carried out a case-control study patients eight tertiary care hospitals Canada between January 2011 December 2013. Cases were defined as women diagnosis hemorrhage, controls (without hemorrhage) matched cases by hospital date delivery. Estimated compared controls. Conditional logistic regression was used to adjust for confounding. The included 383 had significantly higher mean estimated loss than However, 16.7% who delivered vaginally 34.1% Caesarean section (CS) < 500 mL 1000 mL, respectively; 8.2% 6.7% CS consistent Factors known protective factors (e.g., delivery CS) nulliparity, vaginal birth after CS). Uterotonic use more common (97.6% vs. 92.9%, P 0.001). Delayed cord clamping only among those (7.7% 14.6% controls, = 0.06). There is substantial misclassification this could potentially explain observed temporal increase rates.