Characteristics, causes and treatment of postpartum haemorrhage in first and second pregnancies.

We investigated characteristics, causes and treatment of postpartum haemorrhage (PPH) in a random sample of 294 women's first and second pregnancies involving at least one PPH. Among 588 pregnancies, PPH affected 169 first pregnancies, 105 second pregnancies only and recurrent PPH affected 48 pregnancies. In 34% of PPHs, atony was the primary cause. Second pregnancy PPH involved increased pharmacological therapy, blood transfusion and median blood loss. It is important to ascertain PPH history in parous women and be prepared for PPH recurrence.