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Table 4 Causes of PPH according to mode of delivery

From: Incidence of immediate postpartum hemorrhages in French maternity units: a prospective observational study (HERA study)

Causes of PPHa

Vaginal delivery and PPH

n = 3488

%a

Cesarean and PPH

n = 719

%a

Crude RRb [95 % CI]

p value

Uterine atony

57.7

66.3

1.15 [1.08–1.22]

<.0001

Placental retention

38.7

2.6

0.07 [0.04–0.11]

<.0001

Vaginal and/or perineal lacerations

24.9

1.7

-

-

Episiotomy

19.4

0.8

-

-

Anomaly of placental insertion

1.9

12.7

-

-

Uterine rupturec

0.4

1.7

4.15 [1.93–8.95]

-

Cervical lacerations

3.4

0.8

-

-

Vaginal thrombus

1.3

0.4c

-

-

Others

 intraoperative complications

0.1

16.4

190.81 [60.84–598.46]

<.0001

 hemorrhagic normal 3rd staged

0.3

0.1

-

-

 amniotic fluid embolism

0.1

0.1

-

-

 uterine inversion

0.1

0.0

-

-

 coagulation disorders

0.2

2.6

-

-

 not determinede

1.6

8.5

-

-

  1. aOne woman could have had several causes that explain her PPH
  2. bcesareans vs. vaginal deliveries
  3. cThere were 3 trials of vaginal delivery (1 woman with an episiotomy and placental retention, 1 woman with no other anomaly, and 1 woman with a uterine rupture and a vaginal laceration)
  4. dHemorrhagic normal third stage: excessive blood loss during a normal separation of the placenta from the uterine wall
  5. eThe professionals were unable to select a principal cause for the PPH