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  • Title: [Incidence and factors related to excessive intrapartum blood loss].
    Author: Romero-Arias AI, Luján-Prior M, Pernia-Fernández J, Hernández-Martínez A.
    Journal: Enferm Clin; 2011; 21(5):256-63. PubMed ID: 21944931.
    Abstract:
    INTRODUCTION: Childbirth and postpartum carry a high potential risk to the woman, with bleeding being a major cause of morbidity and mortality. A drop in haemoglobin ≥ 3.5 g during the delivery process is considered as excessive bleeding, and is used as an indicator of quality of care in childbirth. OBJECTIVE: To determine the incidence and factors associated with excessive intrapartum blood loss. SUBJECTS AND METHODS: Hybrid design nested case-control study was performed in a cohort of 1488 pregnant women who gave birth at the Hospital La Mancha-Centro in 2008. We selected all the cases (84 subjects with a haemoglobin loss of ≥ 3.5 g) and twice the number of controls (164) matched by time of delivery. Multivariate analysis was performed using conditional logistic regression. RESULTS: The incidence of excessive intrapartum bleeding was 6.6%, with no significant differences regarding the mode of delivery (Vaginal and Caesarean=6.8%=5.6%). Antepartum anaemia was around 10% and postpartum anaemia 41.4%. We found no factors associated with bleeding in Caesarean deliveries. However, in the vaginal primiparity, manual removal and particularly the practice of episiotomy [OR=4.82 (95% CI, 1.73 to 13.44] are presented as clear risk factors. CONCLUSION: The incidence of excessive bleeding is above recommended levels. Primiparity, manual removal and particularly episiotomy are risk factors for bleeding.
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