RISK FACTORS FOR ATONIC POSTPARTUM HEMORRHAGE: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.53555/nnmhs.v9i8.1790Keywords:
Postpartum hemorrhage, uterine hemorrhage, uterine atony, incidence, factorsAbstract
ABSTRACT
Introduction: Postpartum bleeding occurs in 3-10% of all deliveries. Although numerous causes exist, uterine atony is the most frequent, accounting for about 70% of all instances.
Objective: This study aimed to identify and quantify risk variables for atonic postpartum hemorrhage.
Methods: The databases PubMed, CINAHL, EMBASE, Web of Science, and ClinicalTrials.gov were searched for English language studies with no date or geographical constraints. Randomized trials, prospective or retrospective cohort studies, and case-control studies of pregnant individuals who suffered atonic postpartum hemorrhage and reported at least one risk factor were included in the studies. This review contained 16 studies out of the 1,977 records evaluated. A qualitative synthesis of research with low and moderate risk of bias rates each risk factor as definite, likely, unclear, or not a risk factor.
Results: This research found 47 potential risk factors for atonic postpartum hemorrhage, 15 of which were deemed definite or likely risk factors. The remaining 32 risk factors were unrelated to atonic postpartum hemorrhage or had inconsistent or inconclusive data.
Conclusion: A significant proportion of postpartum bleeding occurs without known risk factors. Many risk variables for atonic hemorrhage contained in existing risk assessment tools were confirmed, with past postpartum hemorrhage of any cause, placenta previa, placental abruption, uterine rupture, and multiple pregnancies conferring the largest risk. Hypertension, diabetes, and ethnicity were new risk factors not previously included in risk-assessment systems. In this study, obesity and magnesium were not associated with to atonic postpartum hemorrhage.
References
. Sosa CG, Althabe F, Belizán JM, Buekens P. Risk factors for postpartum hemorrhage in vaginal deliveries in a Latin-American population. Obstet Gynecol. 2009;113(6).
. Bateman BT, Berman MF, Riley LE, Leffert LR. The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg. 2010;110(5).
. Neary C, Naheed S, McLernon DJ, Black M. Predicting risk of postpartum haemorrhage: a systematic review. Vol. 128, BJOG: An International Journal of Obstetrics and Gynaecology. 2021.
. Girard T, Mörtl M, Schlembach D. New approaches to obstetric hemorrhage: The postpartum hemorrhage consensus algorithm. Vol. 27, Current Opinion in Anaesthesiology. 2014.
. Atallah F, Goffman D. Bundles for maternal safety: Promises and challenges of bundle implementation: The case of obstetric hemorrhage. Clin Obstet Gynecol. 2019;62(3).
. Dilla AJ, Waters JH, Yazer MH. Clinical validation of risk stratification criteria for peripartum hemorrhage. Obstet Gynecol. 2013;122(1).
. Kawakita T, Mokhtari N, Huang JC, Landy HJ. Evaluation of Risk-Assessment Tools for Severe Postpartum Hemorrhage in Women Undergoing Cesarean Delivery. Obstet Gynecol. 2019;134(6).
. Durmaz A, Komurcu N. Relationship between Maternal Characteristics and Postpartum Hemorrhage: A Meta-Analysis Study. J Nurs Res. 2018;26(5).
. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Rev Esp Nutr Humana y Diet. 2016;20(2).
. Morris JA, Gardner MJ. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed). 1988;296(6632).
. Bateman BT, Hernandez-Diaz S, Huybrechts KF, Palmsten K, Mogun H, Ecker JL, et al. Outpatient calcium-channel blockers and the risk of postpartum haemorrhage: A cohort study. BJOG An Int J Obstet Gynaecol. 2013;120(13).
. Bryant A, Mhyre JM, Leffert LR, Hoban RA, Yakoob MY, Bateman BT. The association of maternal race and ethnicity and the risk of postpartum hemorrhage. Anesth Analg. 2012;115(5).
. Foley A, Gunter A, Nunes KJ, Shahul S, Scavone BM. Patients undergoing cesarean delivery after exposure to oxytocin during labor require higher postpartum oxytocin doses. Anesth Analg. 2018;126(3).
. Joseph KS, Sheehy O, Mehrabadi A, Urquia ML, Hutcheon JA, Kramer M, et al. Can Drug Effects Explain the Recent Temporal Increase in Atonic Postpartum Haemorrhage? Paediatr Perinat Epidemiol. 2015;29(3):220–31.
. Kahr MK, Franke D, Brun R, Wisser J, Zimmermann R, Haslinger C. Blood group O: A novel risk factor for increased postpartum blood loss? Haemophilia. 2018;24(4).
. Kovacheva VP, Soens MA, Tsen LC. Serum uric acid as a novel marker for uterine atony and post-spinal vasopressor use during cesarean delivery. Int J Obstet Anesth. 2013;22(3).
. Looft E, Simic M, Ahlberg M, Snowden JM, Cheng YW, Stephansson O. Duration of Second Stage of Labour at Term and Pushing Time: Risk Factors for Postpartum Haemorrhage. Paediatr Perinat Epidemiol. 2017;31(2).
. Wetta LA, Szychowski JM, Seals S, Mancuso MS, Biggio JR, Tita ATN. Risk factors for uterine atony/postpartum hemorrhage requiring treatment after vaginal delivery. Am J Obstet Gynecol. 2013;209(1).
. Tran G, Kanczuk M, Balki M. The association between the time from oxytocin cessation during labour to Cesarean delivery and postpartum blood loss: a retrospective cohort study. Can J Anesth. 2017;64(8).
. A.L. R, E. A, G.V. LG, C. P, M. R. Logistic regression analysis highlighted previous atony, pre-eclampsia, oxytocin induction and augmentation of labour, macrosomia, slow labour, Kristeller manoeuvres to be risk factors for uterine atony. Vol. 13, Italian Journal of Gynaecology and Obstetrics. 2001.
. Oberg AS, Hernandez-Diaz S, Palmsten K, Almqvist C, Bateman BT. Patterns of recurrence of postpartum hemorrhage in a large population-based cohort. In: American Journal of Obstetrics and Gynecology. 2014.
. Guillaume A, Sananès N, Poirier V, Gaudineau A, Fritz G, Boudier E, et al. Benefits of cord blood collection in the prevention of post-partum hemorrhage: A cohort study. J Matern Neonatal Med. 2015;28(17).
. Vendittelli F, Barasinski C, Pereira B, Lémery D. Incidence of immediate postpartum hemorrhages in French maternity units: A prospective observational study (HERA study). BMC Pregnancy Childbirth. 2016;16(1).
. Chalouhi SE, Tarutis J, Barros G, Starke RM, Mozurkewich EL. Risk of postpartum hemorrhage among Native American women. Int J Gynecol Obstet. 2015;131(3).
. Mehrabadi A, Hutcheon JA, Lee L, Kramer MS, Liston RM, Joseph KS. Epidemiological investigation of a temporal increase in atonic postpartum haemorrhage: A population-based retrospective cohort study. BJOG An Int J Obstet Gynaecol. 2013;120(7).
. Leonard SA, Main EK, Scott KA, Profit J, Carmichael SL. Racial and ethnic disparities in severe maternal morbidity prevalence and trends. Ann Epidemiol. 2019;33.
. Obermeyer Z, Powers B, Vogeli C, Mullainathan S. Dissecting racial bias in an algorithm used to manage the health of populations. Science (80- ). 2019;366(6464).
. Huang D, Refaat M, Mohammedi K, Jayyousi A, Al Suwaidi J, Abi Khalil C. Macrovascular Complications in Patients with Diabetes and Prediabetes. Vol. 2017, BioMed Research International. 2017.
. Dinh QN, Drummond GR, Sobey CG, Chrissobolis S. Roles of inflammation, oxidative stress, and vascular dysfunction in hypertension. Vol. 2014, BioMed Research International. 2014.
. Turbeville HR, Sasser JM. Preeclampsia beyond pregnancy: Long-term consequences for mother and child. Vol. 318, American Journal of Physiology - Renal Physiology. 2020.
. Metin Gülmezoglu A, Lumbiganon P, Landoulsi S, Widmer M, Abdel-Aleem H, Festin M, et al. Active management of the third stage of labour with and without controlled cord traction: A randomised, controlled, non-inferiority trial. Lancet. 2012;379(9827).
. Tunçalp Ö, Souza JP, Gülmezoglu M. New WHO recommendations on prevention and treatment of postpartum hemorrhage. Int J Gynecol Obstet. 2013;123(3).
. Dyer RA, Butwick AJ, Carvalho B. Oxytocin for labour and caesarean delivery: Implications for the anaesthesiologist. Curr Opin Anaesthesiol. 2011;24(3).
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Journal of Advance Research in Medical & Health Science (ISSN: 2208-2425)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
