Risk factors for postpartum hemorrhage among Saudi women.

OBJECTIVE To identify health-related risk factors for the development of post partum hemorrhage (PPH) in Saudi women and to estimate the incidence of primary PPH. METHODS A case-control study was conducted between July 1, 2007 and June 30, 2008 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. One hundred and one patients with PPH and 209 control patients were included. Bivariate associations between the different risk factors for the development of PPH were studied. Multivariate logistic regression analysis to identify significant risk factors for the occurrence of this obstetrics complication was carried out. RESULTS High parity was associated with a 17% increased risk of PPH. Risk factors in preeclampsia was associated with >6-fold increase. History of antepartum hemorrhage (APH) increased the risk for PPH by >8-fold. Other factors were: multiple pregnancy, vaginal delivery, prolonged third stage of labor, and presence of cardiotocograph (CTG) abnormalities. CONCLUSION Risk factors for developing PPH among Saudi women are comparable to other reported studies with a greater influence of parity, presence of APH, multiple gestation, CTG abnormalities and prolonged third stage of labor. There is a need for patient education on family planning and antenatal care, physician education on active management of the third stage, and correct estimation of blood loss.