Critical concept of risk postpartum readmission following postpartum hemorrhage: A multicenter prospective cohort study

Abstract

Postpartum hemorrhage (PPH) is a leading cause of maternal mortality and morbidity. Therefore, risk factors need to be investigated to control for this serious complication and prevent readmission. The objective of this study is analysis the risk of postpartum readmission for postpartum hemorrhage within sixty days from a delivery hospitalization. Between January 2017 and February 2018, 369 women age 16-45 years enrolled in a prospective cohort study that conducted at Al-Manathera and Al- Zahraa hospitals/ Najaf in Iraq. We evaluated any readmission that occurred within 60 days after delivery hospitalization discharge by Adjusted log linear regression models for only the first readmissions was included in the analysis. A total of 369 patients had a diagnosis of PPH during their delivery in hospital ((214(58%) normal vaginal delivery and 155(42%) caesarian section)); of these 62.4% had isolated PPH, 18.8% had PPH with placenta previa, 12.6% had PPH with hypertention,10.4% had PPH with DIC, 2.6% had a PPH with pregestational DM, and 1.2% had a PPH with gestational DM. Overall 19(7.011) women were readmitted for a primary indication of postpartum hemorrhage. PPH readmissions were most common 1-14 days after discharge (78% of readmissions) and 15-25 days after discharge (13% of readmissions). 5% of readmissions occurred 26-35 days after discharge and 1% occurred 35-60 days after discharge. In conclusion, this data show that the women at high risk of PPH needs close follow up to prevent of readmission for postpartum hemorrhage.