Increasing incidence of postpartum hemorrhage: the Dutch piece of the puzzle.

Autor:	van Stralen G; Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands. gielvs@gmail.com., von Schmidt Auf Altenstadt JF; Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands., Bloemenkamp KW; Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.; Department of Obstetrics, Wilhelmina Children Hospital Birth Center, Division Woman and Baby, University Medical Center Utrecht, Utrecht, The Netherlands., van Roosmalen J; Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Hukkelhoven CW; Perined, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2016 Oct; Vol. 95 (10), pp. 1104-10. Date of Electronic Publication: 2016 Aug 23.
DOI:	10.1111/aogs.12950
Abstrakt:	Introduction: An increase of postpartum hemorrhage (PPH) has been reported in many high-income countries. In addition to this data, this study reports on trends in the incidence of PPH in the Netherlands in 2000-2013, and examines the extent to which temporal changes in risk indicators could explain a possible change in incidence of PPH. Material and Methods: We used data from the Dutch Perinatal Registry, which contains prospectively collected antenatal, peripartum and neonatal data of 95-99% of all women and neonates in the Netherlands. We selected births ≥22 weeks of gestation from January 2000 until December 2013. Changes in the incidence of PPH and its risk indicators were studied over time. Main outcome measure was PPH, defined as blood loss >1000 mL within 24 h following delivery. Results: The data comprised 2 406 784 women. The incidence of PPH rose significantly from 4.1% in 2000 to 6.4% in 2013 (p < 0.0001). The incidence of previously identified risk indicators for PPH increased over time. Manual removal of placenta was strongly associated with PPH (OR 29.3, CI 28.8-29.8). The incidence of PPH-related blood transfusion decreased remarkably. Conclusions: In line with international observations, Dutch data suggest a considerable increase in the incidence of PPH which can only partly be explained by the studied risk indicators. The decreasing incidence of obstetric blood transfusion suggests an increased incidence of blood loss of 1000-1500 mL. (© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.)
Databáze:	MEDLINE
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