nach oben

Archives of Gynecology and Obstetrics

Erschienen in:

29.09.2016 | Maternal-Fetal Medicine

Risk factors for post-partum hemorrhage following vacuum assisted vaginal delivery

verfasst von: Liran Hiersch, Riki Bergel-Bson, Dorit Asher, Amir Aviram, Rinat Gabby-Benziv, Yariv Yogev, Eran Ashwal

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Objective

To identify risk factors for post-partum hemorrhage (PPH) following vacuum assisted vaginal delivery (VAVD).

Study design

A retrospective study of all women with singleton pregnancies who underwent VAVD in a tertiary hospital (2012–2014). PPH was defined as any of the following: ≥500 ml estimated blood loss, hemoglobin drop ≥3 g/dl (difference between pre- and post-VAVD hemoglobin levels) or the need for blood products transfusion. Characteristics of women with PPH following VAVD were compared to those of women with no PPH following VAVD.

Results

Of 1,154 VAVDs, 295 (25.6 %) had PPH. Women in the PPH group were more often nulliparous (83.1 vs. 70.5 %, p = 0.001) and had higher rate of hypertensive disorders (4.4 vs. 1.4 %, p = 0.001). The rate of episiotomy (87.8 vs. 81.6 %, p = 0.01) was higher in the PPH group. In multivariate analysis, risk factors for PPH were (Odds Ratio, 95 % Confidence Interval) hypertensive disorders (2.40, 1.03–5.58, p = 0.04), induction of labor (1.42, 1.01–2.10, p = 0.04) and longer second (1.003, 1.001–1.006, p = 0.03) and 3rd (1.02, 1.01–1.04, p = 0.004) stages of labor.

Conclusion

Risk factors for PPH following VAVD can be identified and should be taken into consideration at the immediate post-partum period.

American College of Obstetricians and Gynecologists (2015) Practice bulletin No. 154: operative vaginal delivery. Obstet Gynecol 126:56–65CrossRef

Cargill YM, MacKinnon CJ (2004) Guidelines for operative vaginal birth. SOGC clinical practice guidelines. J Obstet Gynaecol Can 26:747–753CrossRefPubMed

Unzila AA, Errol RN (2009) Vacuum-assisted vaginal delivery. Rev Obstet Gynecol 2:5–17

Sheldon WR, Blum J, Vogel JP, Souza JP, Gülmezoglu AM, Winikoff B (2014) Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health. Br J Obstet Gynaecol 121:5–13CrossRef

Mehrabadi A, Hutcheon JA, Lee L, Liston RM, Joseph KS (2012) Trends in postpartum hemorrhage from 2000 to 2009: a population-based study. BMC Pregnancy Childbirth 12:108CrossRefPubMedPubMedCentral

Joseph KS, Rouleau J, Kramer MS, Young DC, Liston RM, Basketta TF (2007) Investigation of an increase in postpartum haemorrhage in Canada. Br J Obstet Gynaecol 114:751–759CrossRef

Bateman BT, Berman MF, Riley LE, Leffert LR (2010) The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg 110:1368–1373CrossRefPubMed

Kramer MS, Berg C, Abenhaim H et al (2013) Incidence, risk factors, and temporal trends in severe postpartum hemorrhage. Am J Obstet Gynecol 209:449.e1-7CrossRefPubMed

Haeri S, Dildy GA (2012) Maternal mortality from hemorrhage. Elsevier Inc. Semin Perinatol 36:48–55CrossRefPubMed

10.

Fong A, Leake J, Pan D, Ogunyemi D (2010) Demographic, institutional and obstetrical risk factors for postpartum haemorrhage mortality. J Obstet Gynaecol 30:470–475CrossRefPubMed

11.

Sheiner E, Saris L, Levy A, Seidman DS, Hallak M (2005) Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study. J Matern Fetal Neonatal Med 18:149–154CrossRefPubMed

12.

Briley A, Seed PT, Tydeman G et al (2014) Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study. Br J Obstet Gynaecol 121:876–888CrossRef

13.

Rath WH (2011) Postpartum hemorrhage—update on problems of definitions and diagnosis. Acta Obstet Gynecol Scand 90:421–428CrossRefPubMed

14.

Tunçalp O, Souza JP, Gülmezoglu M (2013) New WHO recommendations on prevention and treatment of postpartum hemorrhage. Int J Gynaecol Obstet 123:254–256CrossRefPubMed

15.

Grobman WA, Bailit JL, Rice MM et al (2014) Frequency of and factors associated with severe maternal morbidity. Obstet Gynecol 123:804–810CrossRefPubMedPubMedCentral

16.

Oyelese Y, Ananth C (2010) Postpartum hemorrhage: epidemiology, risk factors, and causes. Clin Obstet Gynecol 53:147–156CrossRefPubMed

17.

Say L, Chou D, Gemmill A et al (2014) Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2:323–333CrossRef

18.

Dolberg S, Haklai Z, Mimouni FB, Gorfein I, Gordon ES (2005) Birth weight standards in the live-born population in Israel. Isr Med Assoc J 7:311–314

19.

American College of Obstetricians and Gynecologists (2013) Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Obstet Gynecol 122:1122–1131CrossRef

20.

American College of Obstetricians and Gynecologists (2006) Practice bulletin No. 76: postpartum hemorrhage. Obstet Gynecol 108:1039–1047CrossRef

21.

Carroli G, Cuesta C, Abalos E, Gulmezoglu EM (2008) Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol 22:999–1012CrossRefPubMed

22.

Bahl R, Van de Venne M, Macleod M, Strachan B, Murphy DJ (2013) Maternal and neonatal morbidity in relation to the instrument used for mid-cavity rotational operative vaginal delivery: a prospective cohort study. Br J Obstet Gynaecol 120:1526–1533CrossRef

23.

Ford JB, Roberts CL, Simpson JM, Vaughan J, Cameron CA (2007) Increased postpartum hemorrhage rates in Australia. Int J Gynaecol Obstet 98:237–243CrossRefPubMed

24.

Rossen J, Okland I, Nilsen OB, Eggebo TM (2010) Is there an increase of postpartum hemorrhage, and is severe hemorrhage associated with more frequent use of obstetric interventions? Acta Obstet Gynecol Scand 89:1248–1255CrossRefPubMed

25.

Sosa CG, Althabe F, Belizán JM, Buekens P (2009) Risk factors for postpartum hemorrhage in vaginal deliveries in a Latin-American population. Obstet Gynecol 113:1313–1319CrossRefPubMedPubMedCentral

26.

Al-Zirqi I, Vangen S, Forsén L, Stray-Pedersen B (2009) Effects of onset of labor and mode of delivery on severe postpartum hemorrhage. Am J Obstet Gynecol. 201:273e1-9CrossRef

27.

Kiesewetter B, Lehner R (2012) Maternal outcome monitoring: induction of labor versus spontaneous onset of labor—a retrospective data analysis. Arch Gynecol Obstet 286:37–41CrossRefPubMed

28.

Khiredine I, Le Ray C, Dupont C, Rudigoz RC, Bouvier-Colle MH, Deneux-Tharaux C (2013) Induction of labor and risk of postpartum hemorrhage in low risk parturients. PLoS One 8:e54858CrossRef

29.

Grotegut CA, Paglia MJ, Johnson LNC, Thames B, Jams AH (2011) Oxytocin exposure in women with postpartum hemorrhage secondary to uterine atony. Am J Obstet Gynecol 204:1–6CrossRef

30.

Cheng YW, Hopkins LM, Laros RK Jr, Caughey AB (2007) Duration of the second stage of labor in multiparous women: maternal and neonatal outcomes. Am J Obstet Gynecol 196:1–6CrossRef

31.

Le Ray C, Audibert F, Goffinet F, Fraser W (2009) When to stop pushing: effects of duration of second-stage expulsion efforts on maternal and neonatal outcomes in nulliparous women with epidural analgesia. Am J Obstet Gynecol 201:1–7CrossRef

32.

Allen VM, Baskett TF, O’Connell CM, McKeen D, Allen AC (2009) Maternal and perinatal outcomes with increasing duration of the second stage of labor. Obstet Gynecol 113:1248–1258CrossRefPubMed

33.

Biguzzi E, Franchi F, Ambrogi F et al (2012) Risk factors for postpartum hemorrhage in a cohort of 6011 Italian women. Thromb Res 129:1–7CrossRef

34.

Tang YY, Du Y, Ni J, Ma YS, Lin XM, Zhou J (2014) Relaxant effects of metoclopramide and magnesium sulfate on isolated pregnant myometrium: an in vitro study. Int J Obstet Anesth 23:131–137CrossRefPubMed

35.

Szal SE, Croughan-Minihane MS, Kilpatrick SJ (1999) Effect of magnesium prophylaxis and preeclampsia on the duration of labor. Am J Obstet Gynecol 180:1475–1479CrossRefPubMed

36.

Witlin AG, Friedman SA, Sibai BM (1997) The effect of magnesium sulfate therapy on the duration of labor in women with mild preeclampsia at term: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 176:623–627CrossRefPubMed

Titel: Risk factors for post-partum hemorrhage following vacuum assisted vaginal delivery
verfasst von: Liran Hiersch
Riki Bergel-Bson
Dorit Asher
Amir Aviram
Rinat Gabby-Benziv
Yariv Yogev
Eran Ashwal
Publikationsdatum: 29.09.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 1/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-016-4208-5

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Risk factors for post-partum hemorrhage following vacuum assisted vaginal delivery