TY - JOUR
T1 - Factors associated with acute postpartum hemorrhage in low-risk women delivering in rural India
AU - Geller, Stacie E.
AU - Goudar, Shivaprasad S.
AU - Adams, Marci G.
AU - Naik, Vijaya A.
AU - Patel, Ashlesha
AU - Bellad, Mrutyunjaya B.
AU - Patted, Shobhana S.
AU - Edlavitch, Stanley A.
AU - Moss, Nancy
AU - Kodkany, Bhalchandra S.
AU - Derman, Richard J.
N1 - Funding Information:
Funding for this study was provided by the NICHD grant # 1 U01 HD42372-01 and the Bill and Melinda Gates Foundation to the UMKC-UIC-JNMC Women's and Children's Research Unit.
PY - 2008/4
Y1 - 2008/4
N2 - Objective: Postpartum hemorrhage (PPH), a major cause of maternal mortality and morbidity in low-income countries, can occur unpredictably. This study examined the sociodemographic, clinical, and perinatal characteristics of low-risk women who experienced PPH. Methods: This analysis was conducted using data on 1620 women from a randomized trial testing oral misoprostol for prevention of PPH in rural India. Results: Of the women, 9.2% experienced PPH. No maternal or sociodemographic factors and few perinatal factors differed between women with PPH and those without, other than treatment with misoprostol. Having fewer than 4 prenatal visits and lack of iron supplementation increased the risk for PPH (P < 0.001 and P = 0.037, respectively). Several factors unknown until the second stage of labor (perineal tear and birth weight) were also associated (P = 0.003). Conclusions: Among women at low risk for PPH, there were few factors associated with further risk. Given that PPH can occur without warning, rural communities should consider ways to increase both primary prevention (iron supplementation, AMTSL) and secondary prevention of PPH (availability of obstetric first aid, availability of transport, and availability of emergency obstetric care).
AB - Objective: Postpartum hemorrhage (PPH), a major cause of maternal mortality and morbidity in low-income countries, can occur unpredictably. This study examined the sociodemographic, clinical, and perinatal characteristics of low-risk women who experienced PPH. Methods: This analysis was conducted using data on 1620 women from a randomized trial testing oral misoprostol for prevention of PPH in rural India. Results: Of the women, 9.2% experienced PPH. No maternal or sociodemographic factors and few perinatal factors differed between women with PPH and those without, other than treatment with misoprostol. Having fewer than 4 prenatal visits and lack of iron supplementation increased the risk for PPH (P < 0.001 and P = 0.037, respectively). Several factors unknown until the second stage of labor (perineal tear and birth weight) were also associated (P = 0.003). Conclusions: Among women at low risk for PPH, there were few factors associated with further risk. Given that PPH can occur without warning, rural communities should consider ways to increase both primary prevention (iron supplementation, AMTSL) and secondary prevention of PPH (availability of obstetric first aid, availability of transport, and availability of emergency obstetric care).
KW - India
KW - Maternal mortality
KW - Postpartum hemorrhage
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U2 - 10.1016/j.ijgo.2007.08.025
DO - 10.1016/j.ijgo.2007.08.025
M3 - Review article
C2 - 18291401
AN - SCOPUS:40649126647
SN - 0020-7292
VL - 101
SP - 94
EP - 99
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -
