07 June 2024 : Clinical Research
Risk Factors for Postpartum Hemorrhage in Severe Pre-Eclampsia: A Retrospective Single-Centre Study of 1953 Cases
Yingzi Pan1ABCDE, Yuchuan Wang1ABCDE, Jiayan Miao1ABCDEF, Xiaohong Ji1BCEF, Chengqian Wu1ABC, Yixiao Wang1ABCDEF*, Hongjuan Ding1ABCDEFGDOI: 10.12659/MSM.943772
Med Sci Monit 2024; 30:e943772
Table 2 Clinical characteristics between severe pre-eclampsia with postpartum hemorrhage and without postpartum hemorrhage.
| PPH (n=197) | Non-PPH (n=1756) | P | |
|---|---|---|---|
| Lower limb edema, n (%) | 15 (7.61) | 227 (12.93) | 0.032* |
| PROM, n (%) | 29 (14.72) | 180 (10.25) | <0.001*** |
| Histological chorioamnionitis, n (%) | 21 (10.66) | 231 (13.15) | 0.322 |
| Placental abruption, n (%) | 6 (3.05) | 35 (1.99) | 0.475 |
| HELLP syndrome, n (%) | 7 (3.55) | 39 (2.22) | 0.357 |
| Thrombocytopenia, n (%) | 12 (6.09) | 58 (3.30) | 0.046* |
| Liver dysfunction., n (%) | 12 (6.09) | 86 (4.90) | 0.467 |
| Renal dysfunction, n (%) | 3 (1.52) | 19 (1.08) | 0.842 |
| ICP, n (%) | 11 (5.58) | 85 (4.84) | 0.647 |
| Placenta accreta spectrum disorders, n (%) | 10 (5.08) | 11 (0.63) | <0.001*** |
| Placenta previa, n (%) | 13 (6.60) | 31 (1.77) | <0.001*** |
| GDM, n (%) | 49 (24.87) | 470 (26.77) | 0.569 |
| Hypothyroidism, n (%) | 21 (10.66) | 181 (10.31) | 0.878 |
| Uterine scar, n (%) | 24 (12.18) | 277 (15.77) | 0.186 |
| Mode of delivery, n (%) | |||
| Cesarean section | 165 (83.76) | 1543 (87.87) | 0.098 |
| Vaginal delivery | 32 (16.24) | 213 (12.13) | |
| Induction of labor before delivery, n (%) | 35 (17.77) | 236 (13.44) | 0.096 |
| Cook’s balloon | 11 (5.58) | 70 (3.99) | 0.286 |
| Dinoprostone E26 | 4 (2.03) | 22 (1.25) | 0.565 |
| Oxytocin | 32 (16.24) | 220 (12.53) | 0.140 |
| Medicationy, n (%) | 190 (96.45) | 1685 (95.96) | 0.739 |
| Labetalol hydrochloride | 182 (92.39) | 1594 (90.77) | 0.455 |
| Nifedipine | 91 (46.19) | 940 (53.53) | 0.050 |
| Phentolamine | 28 (14.21) | 286 (16.29) | 0.452 |
| Magnesium sulfate | 98 (49.75) | 1102 (62.76) | <0.001*** |
| Anesthesia, n (%) | |||
| Spinal anesthesia | 153 (77.66) | 1495 (85.14) | 0.006** |
| General anesthesia | 12 (6.09) | 48 (2.73) | 0.010* |
| Peridural analgesia | 195 (98.98) | 1731 (98.58) | 0.886 |
| Number of blood transfusions, n (%) | 52 (26.40) | 14 (0.80) | <0.001*** |
| Red blood cells suspension | 49 (24.87) | 18 (1.03) | <0.001*** |
| Cryoprecipitate | 10 (5.08) | 5 (0.28) | <0.001*** |
| Fresh frozen plasma | 43 (21.83) | 20 (1.14) | <0.001*** |
| Platelet | 11 (5.58) | 12 (0.68) | <0.001*** |
| Premature labor, n (%) | 111 (56.35) | 960 (54.67) | 0.654 |
| Fetal distress, n (%) | 24 (12.18) | 199 (11.33) | 0.722 |
| Birth weight (g), median (IQR) | 2630.00 (1080.00) | 2500.00 (1240.00) | 0.001** |
| FGR, n (%) | 52 (26.40) | 644 (36.67) | 0.004** |
| Excessive amniotic fluid, n (%) | 4 (2.03) | 46 (2.62) | 0.620 |
| Insufficient amniotic fluid, n (%) | 5 (2.54) | 124 (7.06) | 0.015* |
| Length of hospital stay (days), median (IQR) | 7.00 (3.00) | 7.00 (2.00) | 0.002** |
| Postoperative infection, n (%) | 9 (4.58) | 51 (2.90) | 0.199 |
| Hematoma, n (%) | 2 (1.02) | 2 (0.11) | 1.000 |
| Relaparotomy for hemostatic procedures, n (%) | 10 (5.08) | 1 (0.06) | <0.001*** |
| Hysterectomy, n (%) | 0 (0.00) | 2 (0.11) | 1.000 |
| PPH – postpartum hemorrhage; PROM – premature rupture of the membranes; ICP – intrahepatic cholestasis during pregnancy; GDM – gestational diabetes mellitus; FGR – fetal growth restriction. | |||