Impact of major obstetric hemorrhage in extremely severe maternal morbidity

Abstract

Introduction: Hemorrhage is the most significant complication during pregnancy, mainly in the third and fourth stage of labor.
Objectives: To characterize the pregnant women with major obstetric hemorrhage as a cause of extremely severe maternal morbidity.
Methods: Observational, cross-sectional and developing study performed in ¨Mariana Grajales¨ teaching gynecobstetric hospital in Villa Clara from January 2012 to December 2014. The study population was made up of 46 women who had major obstetric hemorrhage. Data were taken from review of documents from the delivery register and medical histories. For the statistical analysis, Chi square test was used to identify association among variables. The non-parametric test of the median´s test was applied to find differences among the groups by cause of hemorrhage.
Results: Predominance of patients with one or more deliveries with 78.3% and uterus atony as an essential cause of hemorrhage with 45.7% of cases. Postpartum hemorrhage occurred in 71.7% of the group.
Conclusions: Major obstetric hemorrhage occurs more frequently at ages of 20 to 35 years and in women with one or more deliveries in their obstetric history. Uterus atony remains the first cause of major obstetric hemorrhage and the puerperium is the most critical time for extremely severe maternal morbidity from hemorrhage.