Postpartum Hemorrhagic Morbidities with Livebirth versus Stillbirth
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Le résumé fourni par la source
Objective: ACOG publications on stillbirth or postpartum hemorrhage (PPH) do not consider stillbirth as a risk factor for postpartum hemorrhagic morbidity. This study aimed to ascertain the likelihood of composite maternal hemorrhagic outcome (CMHO) among individuals who delivered vaginally with livebirth versus a stillbirth. Study Design: This was a retrospective cohort study of all parturients greater than 20 weeks gestation who delivered vaginally at a single level IV site within 24 months. Demographic differences and baseline PPH risks were analyzed. CMHO included any of the following: estimated blood loss ≥1,000 mL, use of uterotonics (beyond prophylactic oxytocin), Bakri balloon, surgical management of PPH, blood transfusion, hysterectomy, venous thromboembolism (VTE), admission to the intensive care unit (ICU), or maternal death. Statistical analysis included chi-squared, Kruskal-Wallis, and Poisson regression with robust error variance for risk ratios, adjusting for gestational age (GA), bleeding on admission, chorioamnionitis, and prior uterine surgery. Results: < 0.001) were different in the two groups. CMHO was significantly higher with a stillbirth delivery (32.6 vs. 16.8%; aRR: 1.56, 95% CI: 1.01-2.46). After adjustment, the components of the CMHO that differed significantly were estimated blood loss ≥1,000 mL and ICU admission. Tamponade, surgical intervention, VTE, hysterectomy, and maternal death did not differ between the two groups. Conclusion: Pregnancies with stillbirth, compared with livebirth, had an increased risk of hemorrhagic related morbidity. In addition to being useful in shared decision-making, our results can be nidus for intervention trials to decrease the hemorrhagic morbidity associated with stillbirth. Key Points: · The risk of CMHO was significantly higher in the stillbirth group even after adjustment for potential confounders (32.6% vs. 16.8%).. · Stillbirth was associated with a significantly higher risk of blood loss of ≥1,000 mL.. · Stillbirth was also associated with higher likelihood of uterotonic use, transfusion, and admission to ICU..
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Postpartum Hemorrhagic Morbidities with Livebirth versus Stillbirth
- Date Crossref
- 05/12/2025
- Éditeur
- Georg Thieme Verlag KG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Christiana Care Health System pays non établi dans la noticeÉtablissement de santé
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Sapienza University of Rome Department of Maternal and Child Health and Urological Sciences pays non établi dans la noticeUniversité ou école supérieure
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University of California San Diego Department of Obstetrics pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas Health Science Center Department of Obstetrics pays non établi dans la noticeUniversité ou école supérieure
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The University of Texas Health Science Center at Houston pays non établi dans la noticeUniversité ou école supérieure
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Department of Obstetrics and Gynecology pays non établi dans la noticeInstitution
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University of Rome La Sapienza pays non établi dans la noticeUniversité ou école supérieure
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University of Texas McGovern Medical School Department of Obstetrics pays non établi dans la noticeUniversité ou école supérieure
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Maternal-Fetal Medicine pays non établi dans la noticeInstitution
Christiana Care Health System, Department of Maternal and Child Health and Urological Sciences — Sapienza University of Rome et Department of Obstetrics — University of California San Diego, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.