Does Abnormal Uterine Bleeding in Menstrual Cycles Predispose Postpartum Bleeding? A Prospective Study

Abstract

INTRODUCTION[|]Postpartum bleeding is a life-threatening obstetric problem all over the world, which needs to be well managed to reduce maternal mortality. In this study, we aim to predict postpartum bleeding by menstrual cycles of the patients.[¤]METHODS[|]A prospective, observational, cross-sectional study was conducted between November 2017 and July 2018. All the patients that gave labour in our clinic were evaluated and grouped. Group 1 (n=240) consisted of the patients with regular menstrual cycles, and they had no history of bleeding disorders, Group 2 (n=60) consisted of the patients with abnormal uterine bleeding as >80 mL bleeding in a period, having period before 24 days, >8 days of bleeding in a period or intermenstrual bleeding. However, they had no other history of bleeding disorder. All the patients were screened for bleeding diathesis.[¤]RESULTS[|]The mean age was 28.77+-5.88 years and the mean prepartum hemoglobin was 11.76+-1.36 mg/dl. 118 (39.3%) of the patients had a vaginal delivery and 182 (60.7%) had a cesarean delivery. The mean postpartum hemoglobin was 10.71+-1.49 mg/dl. Group 1 had higher prepartum and postpartum hemoglobin than Group 2 (p=0.001 and p=0.003, respectively). Abnormal uterine bleeding (AUB) was correlated with prepartum (r=0.222, p=0.000) and postpartum hemoglobin (r=0.171, p=0.030). AUB was not significantly related to postpartum bleeding. Regarding fetal outcome, only neonatal intensive care unit admission was significantly related to abnormal uterine bleeding history (p=0.03).[¤]DISCUSSION AND CONCLUSION[|]Postpartum bleeding is not always a predictable status, and patients with abnormal uterine bleeding history should be expected to have lower hemoglobin levels prepartum and postpartum.[¤]

Keywords

• abnormal uterine bleeding
• menorrhagia; menometrorrhagia; postpartum bleeding.