Dube Rajani, Kar Subhranshu Sekhar, Satapathy Sanghamitra, Bahutair Shadha Nasser, Younus Haider Ali, Abdulsalam Khawla Fadil Noori
Department of Obstetrics and Gynecology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
Department of Obstetrics and Gynecology, Jagannath Hospital, Bhubaneswar, Odisha, India.
Ann Afr Med. 2025 Apr 25. doi: 10.4103/aam.aam_55_25.
This study aims to find the correlation between risk factors and the incidence of postpartum hemorrhage (PPH) in normal vaginal deliveries.
The present research is an observational cohort study. Two hundred and thirty-nine women undergoing normal labor who delivered vaginally were given 0.2 mg of Ergometrine or 600 μg of Misoprostol at the delivery of the anterior shoulder, as a prophylaxis to prevent PPH. The blood loss was estimated by the use of blood collection drapes during delivery. All statistical analyses were conducted through SPSS version 27. The risk factors were compared between the groups with or without PPH.
The majority 87 (36.4%) of the participants were in the 25-29 years' age group, 113 were nullipara (47.3%), and 93 (38.9%) were primigravida. The prevalence of PPH was 4.6% (11/239). Almost half of the cases of PPH (5/11, 45.5%) had no risk factors, whereas those with risk factors had twin pregnancy (25%), low-lying placenta (50%), grand multipara (33.3%), and previous history of PPH (33.3%). Furthermore, a moderate positive correlation between the risk factors and the incidence of PPH was observed (R = 0.512).
In this study, women with risk factors such as twin pregnancy, low-lying placenta, grand multipara, and previous history of PPH developed PPH despite prophylaxis and close monitoring. However, almost half of the cases of PPH occurred in people where there was no risk factor. It is recommended that vigilance for the early detection and appropriate preparation for the management of PPH should be followed even in low-risk women undergoing vaginal delivery.
本研究旨在探讨正常阴道分娩中危险因素与产后出血（PPH）发生率之间的相关性。
本研究为观察性队列研究。239名正常分娩的经阴道分娩妇女在娩出前肩时给予0.2mg麦角新碱或600μg米索前列醇，以预防产后出血。分娩期间使用采血巾估计失血量。所有统计分析均通过SPSS 27版进行。比较有无产后出血组的危险因素。
大多数参与者87名（36.4%）年龄在25 - 29岁之间，113名未生育（47.3%），93名初产妇（38.9%）。产后出血的发生率为4.6%（11/239）。几乎一半的产后出血病例（5/11，45.5%）没有危险因素，而有危险因素的病例有双胎妊娠（25%）、前置胎盘（50%）、多产妇（33.3%）和既往产后出血史（33.3%）。此外，观察到危险因素与产后出血发生率之间存在中度正相关（R = 0.512）。
在本研究中，有双胎妊娠、前置胎盘、多产妇和既往产后出血史等危险因素的妇女尽管进行了预防和密切监测仍发生了产后出血。然而，几乎一半的产后出血病例发生在无危险因素的人群中。建议即使是低风险的经阴道分娩妇女也应警惕产后出血的早期发现并做好适当的处理准备。
