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[Hemorrhage after vaginal delivery].

Torbjørn Moe Eggebø, Leif Gjessing

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Abstract

BACKGROUND: Primary postpartum haemorrhage, defined as blood loss of more than 500 ml, is an important cause of maternal morbidity and mortality. MATERIAL AND METHODS: By the use of information registered in a database in 1997-99 at Rogaland Central Hospital 11,681 women with vaginal births were investigated. In 1997 all women received 10 IU oxytocin routinely after delivery, in 1998 and 1999 the use of oxytocin was restricted to special indications. RESULTS: Mean bleeding was 363 ml, 1,123 women (9.6%) had a blood loss of more than 500 ml, and 91 (0.8%) of more than 1,500 ml. First delivery, twins, big baby, induction of labour, epidural analgesia, operative vaginal delivery, episiotomy and tears were associated with increased bleeding. INTERPRETATION: The risk of postpartum haemorrhage seems to be increased with restricted use of oxytocin after delivery.

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What this paper is about

BACKGROUND: Primary postpartum haemorrhage, defined as blood loss of more than 500 ml, is an important cause of maternal morbidity and mortality. MATERIAL AND METHODS: By the use of information registered in a database in 1997-99 at Rogaland Central Hospital 11,681 women with vaginal births were investigated. In 1997 all women received 10 IU oxytocin routinely after delivery, in 1998 and 1999 the use of oxytocin was restricted to special indications. RESULTS: Mean bleeding was 363 ml, 1,123 women (9.6%) had a blood loss of more than 500 ml, and 91 (0.8%) of more than 1,500 ml. First delivery, twins, big baby, induction of labour, epidural analgesia, operative vaginal delivery, episiotomy and tears were associated with increased bleeding. INTERPRETATION: The risk of postpartum haemorrhage seems to be increased with restricted use of oxytocin after delivery.

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Available abstract

BACKGROUND: Primary postpartum haemorrhage, defined as blood loss of more than 500 ml, is an important cause of maternal morbidity and mortality. MATERIAL AND METHODS: By the use of information registered in a database in 1997-99 at Rogaland Central Hospital 11,681 women with vaginal births were investigated. In 1997 all women received 10 IU oxytocin routinely after delivery, in 1998 and 1999 the use of oxytocin was restricted to special indications. RESULTS: Mean bleeding was 363 ml, 1,123 women (9.6%) had a blood loss of more than 500 ml, and 91 (0.8%) of more than 1,500 ml. First delivery, twins, big baby, induction of labour, epidural analgesia, operative vaginal delivery, episiotomy and tears were associated with increased bleeding. INTERPRETATION: The risk of postpartum haemorrhage seems to be increased with restricted use of oxytocin after delivery.

Key concepts: Medicine, Oxytocin, Episiotomy, Vaginal delivery, Postpartum haemorrhage, Blood loss, Obstetrics, Tears

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