Risk Factors for Primary Postpartum Hemorrhage in Bhumibol Adulyadej Hospital
Wibool Rueangchainikhom MD*, Siriwan Srisuwan MD**, Sinart Prommas MD*, Saravut Sarapak BSc (MT)*
Affiliation : * Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Bangkok, Thailand ** Department of Obstetrics and Gynecology, Srinakharinwirot University, Bangkok, Thailand
Background : Postpartum hemorrhage remains one of the main causes of maternal morbidity and mortality in
both developed and developing countries. Hemorrhages account for 28%of all direct maternal deaths and
remain the most common cause of direct maternal deaths worldwide.
Objective : To study the incidence and risk factors for postpartum hemorrhage (PPH) in Bhunibol Adulyadej
Hospital
Material and Method: Retrospective cohort study of 19,429 patients who gave birth between 1st January 2004
and 31st December 2007 at Bhumibol Adulyadej Hospital. One thousand five hundred and thirty women
were enrolled in the present study, three hundred and eighty five women had postpartum hemorrhage and
one thousand one hundred and forty five had no postpartum hemorrhage. The present study analyzed one
postpartum hemorrhage woman compared to three women who gave birth in nearly the same period and had
no postpartum hemorrhage both vaginal deliveries and cesarean section.
Results : The PPH rate in Bhumibol Adulyadej Hospital was 1.98%. Maternal age, height and fetal birth
weight were not different between the PPH group and no PPH group. The strongest risk factors for postpartum
hemorrhage in the present study were prolonged 3rd stage of labor, retained placenta, lacerations of birth
passage, and placenta previa.
Conclusion : The strongest risk factors for postpartum hemorrhage in the present study were prolonged
3rd stage of labor, retained placenta, lacerations of birth passage, and placenta previa.
Keywords : Postpartum hemorrhage, Risk factors
