Differences in Maternal Morbidity Concerning Risk Factors for Obstetric Hemorrhage

A retrospective study was performed to see differences in morbidity concerning risk factors for obstetrical hemorrhage. Mothers receiving any blood transfusion for obstetrical hemorrhage were enrolled. Patients were divided into subgroups according to risk factors for obstetrical hemorrhage. Outcomes of interest included massive blood loss ≥ 3000 ml, massive blood transfusion ≥ 10 units, and invasive procedures for hemostasis, DIC, and maternal death. 153 cases were received blood transfusion. Abruption (n=35, 23%), birth canal tears (n=31, 20%), atonic bleeding (n=23, 15%), and abnormal placental adherence (APA; n=23, 15%) were the four major factors. APA was the highest condition for invasive procedures (78.3%) with a higher incidence of massive blood loss (65.0%) and massive blood transfusion (73.9%). Abruption was the highest condition for DIC (71.4%) with a higher incidence of massive blood transfusion (51.4%). 48.0% of birth canal tears and 39.0% of atonic bleeding were complicated with massive blood loss. Uterine inversion (n=5) included one maternal death. Except for uterine inversion, the ICU admission rate of the remaining conditions was 13~26%. The observed differences in morbidity concerning risk factors for obstetrical hemorrhage may represent important maternal health phenomena in our region. An identification of differences in morbidity concerning risk factors is essential to provide an effective treatment strategy for obstetrical hemorrhage.