Postpartum hemorrhage is related to the hemoglobin levels at labor: Observational study

Abstract

Background: Anemia in pregnancy is common and linked to postpartum hemorrhage in terms of uterine  atony. The more severe the anemia, the more likely the greater blood loss and adverse outcome. The aim of this study was to examine the association between anemic women at labor and postpartum hemorrhage (PPH) during emergency cesarean delivery and to assess the hemoglobin (Hb) values at which the emergency hysterectomy is needed.

Methods and patients: A cross-sectional study was carried out between (Aug. 1st 2012 and Jul. 30th 2013) at Al Thawra General hospital. Fifty-three cases were included in the study.

Results: Postpartum hemorrhage was developed in 53 women (29.1%). Out of 53 women, 21 cases (39.6%)  had severe uterine atony and required emergency hysterectomy and the remaining 32 cases (60.37%)  responded to the conservative measures (p 0.03). Most of the hysterectomized women 80.75% (17/21) had  Hb levels 6 7 versus 12.5% of the nonhysterectomized patients [OR 29.75; 95% CI 6.564–134.53; p <0.01].  There was a strong correlation between low Hb levels and blood loss [r =.619; p< 0.00].

Conclusion: Our study supports the association between anemia (Hb< 10) and the risk of PPH. We also  provide evidence of the association between severe anemia and emergency hysterectomy.