2019, Number 1
Postpartum primary haemorrhage’s risk factors
Language: Spanish
References: 12
Page: 1-12
PDF size: 431.65 Kb.
ABSTRACT
Introduction: Postpartum primary hemorrhage is the leading cause of maternal death in Peru, and it has been directly related to home birth, so it could reflect the opportunity and quality of health services when it occurs during a hospital’s birth.Objective: To identify the risk factors for postpartum primary hemorrhage caused by tearing of the genital tract.
Methods: An analytical study of cases and controls was carried out at Augusto Hernández Mendoza Hospital – EsSalud. The sample was composed by 30 cases (with postpartum primary hemorrhage by tearing of the genital tract) and 120 controls (without postpartum primary hemorrhage). T´s Student and U´s Mann-Whitney tests were used to compare the numerical variables, and the Chi square test to determine the association between the variables. Association´s strength was determined by calculating crude Odds Ratio and it was adjusted with its confidence intervals (CI) to 95% by binary logistic regression with the Hosmer-Leme show goodness-of-fit test.
Results: The average haemoglobin value was 8.85 ± 0.39 mg% in the cases and 11.90 ± 0.13 mg% in the controls (P = 0.000). In the multivariate analysis, the risk predictors were: Nulliparae (ORa = 11.49; IC95% = 3,11-42,42), single (Ora = 8.81; IC95% = 1,83-42,41), < 8 Pre-natal controls (Ora = 7.95; IC95% = 2,60-24,31), and newborn birth weight ≥ 3500 grams (Ora = 7.34; IC95% = 2,15-25,06).
Conclusions: The risk of primary post-partum hemorrhage by tearing of the genital tract was greater in single, nulliparae women, with less than eight prenatal controls and newborns weighing more than 3500 grams.
REFERENCES
Organización Mundial de la Salud. Recomendaciones de la OMS sobre la prevención y el tratamiento de la hemorragia posparto. Información destacada y mensajes clave de las nuevas recomendaciones mundiales de 2012. WHO/RHR/14.20. 2013. Acceso: 05/03/2018. Disponible en:http://apps.who.int/iris/bitstream/10665/120085/1/WHO_RHR_14.20_spa.pdf?ua=1&ua=1
Solari A, Solari C, Wash A, Guerrero M, Enríquez O. Hemorragia del postparto. Principales etiologías, su prevención, diagnóstico y tratamiento. Rev. Med. Clin. Condes. 2014;25(6):993-1003. Acceso: 05/03/2018. Disponible en: http://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-articulo-hemorragia-del-postparto-principales-etiologias-S0716864014706492
Reyes OA. Riesgo de hemorragia posparto en la paciente gran multípara: estudio retrospectivo observacional. Clínica e Investigación en Ginecología y Obstetricia. 2011;38(5):169-72. Acceso: 05/03/2018. Disponible en: http://www.elsevier.es/es-revista-clinica-e-investigacion-ginecologia-obstetricia-7-articulo-riesgo-hemorragia-posparto-paciente-gran-S0210573X10000201