Department of Anesthesia, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
Department of Obstetrics and Gynecology, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
Sci Rep. 2023 Mar 3;13(1):3635. doi: 10.1038/s41598-023-30839-x.
Severe postpartum hemorrhage is an obstetric emergency that needs immediate intervention and is a leading cause of maternal death. Despite its significant health burden, little is known, about its magnitude and risk factors, especially after cesarean delivery in Ethiopia. This study aimed to evaluate the incidence and predictors of severe postpartum hemorrhage following cesarean section. This study was conducted on 728 women who underwent cesarean section. We retrospectively collected data from the medical records, including baseline characteristics, obstetrics, and perioperative data. Potential predictors were investigated using multivariate logistic regression analyses, adjusted odd ratios, and a 95% confidence interval to see associations. A p-value < 0.05 is considered statistically significant. The incidence of severe postpartum hemorrhage was 26 (3.6%). The independently associated factors were previous CS scar ≥ 2 (AOR 4.08: 95% CI 1.20-13.86), antepartum hemorrhage (AOR 2.89: 95% CI 1.01-8.16), severe preeclampsia (AOR 4.52: 95% CI 1.24-16.46), maternal age ≥ 35 years (AOR 2.77: 95% CI 1.02-7.52), general anesthesia (AOR 4.05: 95% CI 1.37-11.95) and classic incision (AOR 6.01: 95% CI 1.51-23.98). One in 25 women who gave birth during cesarean section experienced severe postpartum hemorrhage. Considering appropriate uterotonic agents and less invasive hemostatic interventions for high-risk mothers would help to decrease its overall rate and related morbidity.
产后出血严重是一种产科急症，需要立即干预，是导致产妇死亡的主要原因之一。尽管其对健康的影响巨大，但对其严重程度和危险因素的了解甚少，尤其是在埃塞俄比亚行剖宫产术后。本研究旨在评估剖宫产术后严重产后出血的发生率和预测因素。这项研究共纳入 728 名接受剖宫产术的妇女。我们回顾性地从病历中收集了数据，包括基线特征、产科和围手术期数据。使用多变量逻辑回归分析、调整后的优势比和 95%置信区间来研究潜在的预测因素，以评估其关联。p 值 < 0.05 被认为具有统计学意义。严重产后出血的发生率为 26 (3.6%)。独立相关因素为既往剖宫产术瘢痕≥2 次（OR 4.08：95%CI 1.20-13.86）、产前出血（OR 2.89：95%CI 1.01-8.16）、重度子痫前期（OR 4.52：95%CI 1.24-16.46）、产妇年龄≥35 岁（OR 2.77：95%CI 1.02-7.52）、全身麻醉（OR 4.05：95%CI 1.37-11.95）和经典切口（OR 6.01：95%CI 1.51-23.98）。每 25 名行剖宫产术分娩的妇女中就有 1 名发生严重产后出血。考虑对高危产妇使用适当的子宫收缩剂和微创止血干预措施，有助于降低其总体发生率和相关发病率。
