Post-Birth Bleeding A Growing Danger To Women

Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology;  Blood / Hematology;  Nursing / Midwifery
Article Date: 26 Feb 2009 - 0:00 PDT

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Post-partum haemorrhage (PPH) immediately after giving birth is the largest threat to new mothers in high-income countries. An Australian study, featured in the open access journal BMC Pregnancy and Childbirth, shows that an increasing number of women suffered severe problems arising from blood loss after delivery.

Christine Roberts from the University of Sydney and Royal North Shore Hospital led a team of researchers who studied the birth-hospital discharge records of the 500,603 women who had children in New South Wales during the study period. She said, "We identified 6242 women who suffered severe adverse outcomes, including 22 who died in hospital. Of the 6242, 67% had an obstetric haemorrhage (60% PPH)".

The consequences of adverse maternal outcomes can include infertility, psychological effects, disability and even death. According to Roberts, "Active management of the third stage of labour, delivery of the placenta, is effective in reducing PPH. Unfortunately, adherence to active third-stage management recommendations is poorly reported and/or suboptimal in Australia, and significant variations in policies and practice have been reported in Europe. Suboptimal adherence to active management guidelines could explain the rising PPH rates".

The authors found that between 1999 and 2004 the annual rate of adverse maternal outcomes increased by 20.9%. This increase occurred almost entirely among women who had a PPH. Although adverse outcomes also increased among women with conditions related to high blood pressure, over half these women also had a PPH. Roberts said, "Women with risk factors for PPH, such as a very low placenta or a previous PPH, should give birth in hospitals with facilities to manage severe haemorrhage."

The authors conclude, "We feel that all women should have access to active management of the third stage of labour and careful observation in the first two hours after delivery, as this may reduce the PPH rate and the potential for severe harm and death".

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Notes:

1. Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity
Christine L Roberts, Jane B Ford, Charles S Algert, Jane C Bell, Judy M Simpson and Jonathan M Morris
BMC Pregnancy and Childbirth (in press)
Article available at the journal website: http://www.biomedcentral.com/bmcpregnancychildbirth/
All articles are available free of charge, according to BioMed Central's open access policy.

2. BMC Pregnancy and Childbirth is an open access journal publishing original peer-reviewed research articles in all aspects of pregnancy and childbirth. BMC Pregnancy and Childbirth (ISSN 1471-2393) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE and Google Scholar.

3. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.

Source: Charlotte Webber
BioMed Central

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