Risk factors for postpartum hemorrhage in repeat cesarean delivery: a retrospective study of 2 442 women

Abstract

Objective To investigate the risk factors of postpartum hemorrhage for repeat cesarean delivery by retrospective analysis. Methods Based on the electronic medical records of our hospital during October 2015 and October 2017, clinical data of the women with repeat cesarean delivery, including basic information, maternal characteristics, preoperative conditions, pregnancy-related complications, anesthesia, intra- and post-operative conditions were collected. Logistic regression analysis was performed to investigate the risk factors for postpartum hemorrhage. Results A total of 2 442 patients who met the inclusion and exclusion criteria were included in the analysis. According to the definition of postpartum hemorrhage, they were assigned into the postpartum hemorrhage group (n=346) and the non-postpartum hemorrhage group (n=2 096). Logistic regression analysis indicated that the major risk factors for postpartum hemorrhage were placenta previa (aOR=17.858; 95%CI=8.359~38.149), predelivery anemia (aOR=10.882, 95%CI=6.190~19.129), uterine atony (aOR=6.608, 95%CI=3.604~12.115), and operation time >100 min (aOR=5.202, 95%CI=2.196~12.321; the operation time of the reference group was ≤60 min). Conclusion Placenta previa is the primary risk factors of postpartum hemorrhage for repeat cesarean delivery. In addition, predelivery anemia, uterine atony, placental adhesion, placenta accrete and prolongation of operation time are also closely associated with postpartum hemorrhage.

Keywords

• repeat cesarean delivery
• postpartum hemorrhage
• risk factors