Predictors of postpartum hemorrhage in vaginal deliveries

Abstract

In this study we aimed to identify the risk factors for acute postpartum hemorrhage in pregnant women. We investigated a number of potential risk factors, including the maternal age, gestational age, parity, birth weight, single or multiple pregnancies, episiotomy, tears requiring vaginal or perineal suturing, and placental retention. Data from 1628 deliveries performed from 2019 to 2020 were included. The maternal age ranged between 18 to 41 years, with a mean age of 26.6±3.2 years. The average blood loss postpartum was 234.4±229.7 ml. Among traditionally delivered patients, 309 (18.9%) experienced standard postpartum hemorrhage while of 27 (1.65%) had severe postpartum blood loss. Retained placenta was the major risk factor for both standard and severe postpartum hemorrhage (OR=4.31, 95% CI 1.85-10.04, p<0.001 vs OR=10.25, 95% CI 2.13-49.2, p<0.01). Similarly multiple pregnancy, macrosomia as well as episiotomy was associated with any postpartum hemorrhage. Women with previous history of deliveries and low weight neonates were less likely to experience postpartum hemorrhage (OR=0.69, 95% CI 0.54-0.90, p=0.006 and OR=0.54, 95% CI 0.29-0.97, p=0.04). Risk variables for postpartum hemorrhage were macrosomia, retained placenta, episiotomy, multiple pregnancy, and the necessity for perineal suture.