Vaginal fødsel: All bløding bør målast med same metode

Background: Postpartum haemorrhage (PPH) remains a major cause of maternal mortality and morbidity, and in recent years there has been a temporal increase in the incidence of PPH and associated morbidities in resource rich countries.Individual risk factors for PPH have long been identified but the relative importance of each has been under explored and thus the potential for preventative strategies is unknown.Aim: The aim of this study was to, i) ascertain the incidence of PPH at various thresholds in a South of England population, ii) identify the relative importance of predictor variables associated with PPH at different blood loss thresholds and iii) identify the independent and cumulative association of prepregnancy, pregnancy acquired and intrapartum variables on estimated blood loss following birth.Methodology: A prospective observational study was undertaken in two maternity services.Estimated blood loss data for all women (n=10,213) were imported from NHS electronic summary records.A representative sample of cases (n=1897) was selected for review, using a weighted sampling strategy.Univariate analysis identified variables associated with mean estimated blood loss and PPH at various thresholds.Multivariate regression modelling assessed the association of sequentially acquired variables with PPH ≥500 ml, ≥1000 ml, and ≥1500 ml.Results: The incidence of PPH ≥500 ml, ≥1000 ml ≥1500 ml ≥2000 ml and ≥2500 ml was 33.9% (95%CI 31.4 to 36.5), 9.4% (95%CI 8.5 to 10.4), 4.0% (95%CI 3.4 to 4.6), 2.0% (95%CI 1.6 to 2.4) and 0.8% (95%CI 0.7 to 1.0) respectively.Incidence of PPH ≥1000 ml was investigated by mode of birth.The incidence for spontaneous vaginal birth (SVD) was 4.75% (95%CI0.37 to 3.7) Firstly, I would like to thank my supervisors, Professor Jane Sandall and Dr Rachel Tribe, for their support.I would like to