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Database - (CIANE)

Description of this bibliographical database (CIANE website)
Currently 3108 records
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https://ciane.net/id=983

Created on : 03 Nov 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 1991 ; 77 : 69-76.

Author(s) :

Combs CA, Murphy EL, Laros RK Jr.

Year of publication :

1991

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Les facteurs corrélés de manière significative à l’hémorragie post-partum étaient la prolongation de la 3e phase du travail (facteur de risque 7.56), la pré-éclampsie (5.02), l’épisiotomie médiolatérale (4.67), l’accouchement gémellaire (3.3), l’arrêt de la progression (2.91), les lacérations de tissus tendres (2.05), le travail prolongé (1.66), l’extraction par forceps ou ventouse (1.66), l’ethnicité asiatique (1.73) ou hispanique (1.66), l’épisiotomie médiane (1.58) et la nulliparité (1.45).

Les auteurs avancent l’hypothèse qu’un utérus qui requiert une stimulation du travail est également à risque d’hémorragie par atonie. Ils formulent aussi des hypothèses sur la physiopathologie du lien entre la rétention placentaire et l’HPP: trois raisons possibles qui ne s’excluent pas. En premier lieu, un certain nombre de placenta accreta peuvent être inclus dans ces cas. Deuxièmement, la délivrance artificielle mise en œuvre en cas de rétention placentaire est peut-être à l’origine du risque hémorragique. Enfin, la délivrance retardée peut être le reflet d’une atonie utérine.

(Etude de 9598 accouchements vaginaux, San Francisco CA)

Abstract (English)  :

A case-control study was performed to study risk factors for postpartum hemorrhage. Cases of hemorrhage were defined by a hematocrit decrease of 10 points or more between admission and post-delivery or by the need for red-cell transfusion. Patients with antenatal bleeding were excluded. Among 9598 vaginal deliveries, postpartum hemorrhage occurred in 374 cases (3.9%). Three controls were matched to each case and multiple logistic regression was used to control for covariance among predictor variables. Factors having a significant association with hemorrhage were prolonged third stage of labor (adjusted odds ratio 7.56), preeclampsia (odds ratio 5.02), mediolateral episiotomy (4.67), previous postpartum hemorrhage (3.55), twins (3.31), arrest of descent (2.91), soft-tissue lacerations (2.05), augmented labor (1.66), forceps or vacuum delivery (1.66), Asian (1.73) or Hispanic (1.66) ethnicity, midline episiotomy (1.58), and nulliparity (1.45). These data may help predict postpartum hemorrhage and may be useful in counseling patients about the advisability of home delivery, intravenous access in labor, or autologous blood donation.

Sumário (português)  :

Resumen (español)  :

Comments :

Les auteurs ne trouvent pas de risque hémorragique accru en cas d’analgésie péridurale (OR 0.87, 0.59-1.28 NS).

Argument (français) :

L’épisiotomie médiolatérale est associée à une multiplication par 4.67 du risque d’hémorragie post-partum, et la pré-éclampsie 5.02.

Argument (English):

Factors having a significant association with hemorrhage were prolonged third stage of labor (adjusted odds ratio 7.56), preeclampsia (odds ratio 5.02), mediolateral episiotomy (4.67), previous postpartum hemorrhage (3.55), twins (3.31), arrest of descent (2.91), soft-tissue lacerations (2.05), augmented labor (1.66), forceps or vacuum delivery (1.66), Asian (1.73) or Hispanic (1.66) ethnicity, midline episiotomy (1.58), and nulliparity (1.45).

Argumento (português):

Argumento (español):

Keywords :

➡ placenta previa/accreta ; postpartum hemorrhage ; oxytocin ; episiotomy ; instrumental delivery ; epidural ; eclampsia (pre-)

Author of this record :

Bernard Bel — 03 Nov 2004

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