Prevalence of risk factors for primary postpartum hemorrhage in a university hospital.
Thaís Betti, Helga Geremias Gouveia, Vanessa Aparecida Gasparin and 3 others
PMID 38018607WHAT IT FOUND
Uterine distention and a shock index of 0.9 or higher were the only factors independently linked to postpartum hemorrhage.
The hospital's routine admission risk stratification missed nearly half of the women who bled, so it cannot be relied on to identify those at risk.
Key findings
01After adjusting for other variables, uterine distention and a shock index of 0.9 or higher remained the only factors statistically associated with postpartum hemorrhage.
02Routine risk stratification at admission was not associated with the occurrence of postpartum hemorrhage, and nearly half of the women who developed it had been classified as low risk.
03Postpartum hemorrhage occurred in 30% of the 277 women studied, a rate the authors describe as high compared to international evidence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was conducted at a single university hospital in Brazil over a two-month period, so the results may not apply to other settings or populations. The diagnosis of postpartum hemorrhage was based on medical records of bleeding or interventions, not on quantitative measurement of blood loss, which the authors note is imprecise. Risk stratification was assessed only at admission. Labor and delivery can introduce new risk factors, meaning the stratification may have been outdated by the time of delivery. The sample was selected by convenience and excluded private patients, which may limit generalizability. The study design is cross-sectional, so it can identify associations but cannot prove that uterine distention or shock index caused the hemorrhage.
Declared interests
No conflicts of interest or funding sources are reported in the supplied text.
The easy way to misread this
Do not interpret the 30% prevalence as a universal rate of postpartum hemorrhage. This figure was derived from institutional records of bleeding and interventions, not standardized quantitative blood loss measurement, and the study was conducted in a single high-risk university hospital in Brazil. The authors note that international prevalence rates are lower, and the lack of standardized documentation in the records makes the diagnosis imprecise.