{
    "abstract": "In Brazil, postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Data on the profile of women and risk factors associated with PPH are sparse. This study aimed to describe the profile and management of patients with PPH, and the association of risk factors for PPH with severe maternal outcomes (SMO).\nA cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.\nThe study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.\nThe principal factors associated with poor maternal outcome were being multiparous and placental abruption.",
    "authors": [
        {
            "affiliation": "Instituto de Medicina Integral Prof. Fernando Figueira RecifePE Brazil Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.",
            "firstname": "Mayara Dos Santos Farias Ferreira",
            "initials": "MDSFF",
            "lastname": "Silva"
        },
        {
            "affiliation": "Instituto de Medicina Integral Prof. Fernando Figueira RecifePE Brazil Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.\nUniversidade Federal e Campina Grande Campina GrandePB Brazil Universidade Federal e Campina Grande, Campina Grande, PB, Brazil.",
            "firstname": "Melania Maria Ramos",
            "initials": "MMR",
            "lastname": "de Amorim"
        },
        {
            "affiliation": "Instituto de Medicina Integral Prof. Fernando Figueira RecifePE Brazil Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.",
            "firstname": "Brena",
            "initials": "B",
            "lastname": "Melo"
        },
        {
            "affiliation": "Instituto de Medicina Integral Prof. Fernando Figueira RecifePE Brazil Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.\nTeaching Hospital Universidade Federal de Uberl\u00e2ndia Uberl\u00e2ndiaMG Brazil Teaching Hospital, Universidade Federal de Uberl\u00e2ndia, Uberl\u00e2ndia, MG, Brazil.",
            "firstname": "Andr\u00e9 Vieira",
            "initials": "AV",
            "lastname": "Lanza"
        },
        {
            "affiliation": "Faculdade Pernambucana de Sa\u00fade RecifePE Brazil Faculdade Pernambucana de Sa\u00fade, Recife, PE, Brazil.",
            "firstname": "Maria Eduarda Trigueiro",
            "initials": "MET",
            "lastname": "Ramos"
        },
        {
            "affiliation": "Faculdade Pernambucana de Sa\u00fade RecifePE Brazil Faculdade Pernambucana de Sa\u00fade, Recife, PE, Brazil.",
            "firstname": "Bruna Antunes Dur\u00e3es",
            "initials": "BAD",
            "lastname": "de Carvalho"
        },
        {
            "affiliation": "Faculdade Pernambucana de Sa\u00fade RecifePE Brazil Faculdade Pernambucana de Sa\u00fade, Recife, PE, Brazil.",
            "firstname": "Natalia Nunes",
            "initials": "NN",
            "lastname": "Ten\u00f3rio"
        },
        {
            "affiliation": "Instituto de Medicina Integral Prof. Fernando Figueira RecifePE Brazil Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.",
            "firstname": "Leila",
            "initials": "L",
            "lastname": "Katz"
        }
    ],
    "conclusions": "The principal factors associated with poor maternal outcome were being multiparous and placental abruption.",
    "copyrights": null,
    "doi": "10.61622/rbgo/2024rbgo47\n10.1002/ijgo.14116\n10.1056/NEJMoa2303966\n10.1590/1806-93042020000200016\n10.1002/14651858.CD007412.pub4\n10.1002/14651858.CD001808.pub2\n10.1097/AOG.0000000000002351\n10.1016/j.ejogrb.2019.02.026\n10.1016/j.bpobgyn.2009.01.007\n10.1186/s12884-020-2846-x\n10.1371/journal.pone.0257544\n10.1186/s12884-022-04824-7\n10.1186/s12978-022-01360-7\n10.1371/journal.pone.0263731\n10.1016/j.ijoa.2021.102983\n10.1590/s0104-42302008000300021\n10.1186/s12884-019-2381-9\n10.1016/j.ijoa.2021.103207\n10.1097/AOG.0000000000002781\n10.1016/j.ijgo.2014.08.023\n10.1111/j.1600-0412.2010.01030.x\n10.1111/jog.14834",
    "journal": "Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia",
    "keywords": [
        "Intensive care units",
        "Maternal mortality",
        "Postpartum hemorrhage",
        "Pregnancy"
    ],
    "methods": null,
    "publication_date": "2024-07-12",
    "pubmed_id": "38994461\n35297039\n38170808\n37158447\n23586122\n25730178\n24173606\n29630190\n28937571\n30939360\n30645062\n23918016\n30070803\n19303368\n32183723\n34543331\n35715763\n35264188\n35167600\n33252891\n33994274\n18604406\n30314456\n34391025\n30095761\n25468058\n21241259\n34002432",
    "results": "The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.",
    "title": "The profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study.",
    "xml": "<Element 'PubmedArticle' at 0x788506c37330>"
}