Table 2.
Proportion of obstetric acute renal failure cases (n=502) with postpartum haemorrhage, hypertensive disorders, other risk factors, and mortality or morbidity, Canada (excluding Quebec), 2003-06 and 2007-10
| Risk factor/mortality or morbidity | No of cases 2003-10 | % | P for trend* | |
|---|---|---|---|---|
| 2003-06 (n=212) | 2007-10 (n=290) | |||
| Postpartum haemorrhage: | 148 | 26.9 | 31.4 | 0.34 |
| Atonic | 82 | 12.3 | 19.3 | 0.03 |
| Non-atonic | 66 | 14.6 | 12.1 | 0.27 |
| Non-atonic† | ||||
| Due to retained placenta | 19 | 3.8 | 3.8 | 0.85 |
| Secondary | 9 | 2.4 | 1.4 | 0.37 |
| Due to coagulation defects | 55 | 12.3 | 10.0 | 0.31 |
| Severe postpartum haemorrhage | ||||
| Postpartum haemorrhage+blood transfusion | 93 | 17.5 | 19.3 | 0.64 |
| Postpartum haemorrhage+hysterectomy | 25 | 3.3 | 6.2 | 0.22 |
| Postpartum haemorrhage+other procedures | 15 | 1.9 | 3.8 | 0.23 |
| Any hypertensive disorder: | 316 | 59.0 | 65.9 | 0.05 |
| Pre-existing hypertension | 11 | 1.9 | 2.4 | 0.57 |
| Pre-existing hypertension with proteinuria | 33 | 6.1 | 6.9 | 0.76 |
| Gestational hypertension without proteinuria | 70 | 15.6 | 12.7 | 0.21 |
| Gestational hypertension with proteinuria | 190 | 33.0 | 41.4 | <0.01 |
| Unspecified hypertension | 11 | 3.3 | 1.4 | 0.08 |
| Eclampsia | 16 | 2.8 | 3.5 | 0.66 |
| Maternal age ≥35 years | 143 | 23.6 | 32.1 | 0.07 |
| Nulliparous‡ | 257 | 68.2 | 62.6 | 0.23 |
| Multi-fetal gestation | 50 | 10.4 | 9.7 | 0.66 |
| Previous caesarean | 52 | 9.0 | 11.4 | 0.27 |
| Diabetes | 77 | 15.6 | 15.2 | 0.58 |
| Gestational oedema and proteinuria | 8 | 1.9 | 1.4 | 0.98 |
| Sepsis or other puerperal infection | 60 | 11.3 | 12.4 | 0.93 |
| Antepartum haemorrhage/placenta praevia | 22 | 4.3 | 4.5 | 0.83 |
| Placental abruption | 56 | 11.3 | 11.0 | 0.67 |
| Polyhydramnios | 12 | 2.4 | 2.4 | 0.88 |
| Induction of labour | 158 | 27.8 | 34.1 | 0.30 |
| Caesarean delivery | 335 | 70.8 | 63.8 | 0.38 |
| Uterine rupture | 5 | 0.9 | 1.0 | 0.69 |
| Obstetric shock | 25 | 3.3 | 6.2 | 0.19 |
| Cardiac failure | 35 | 6.6 | 7.2 | 0.29 |
| Amniotic fluid embolism | 6 | 1.4 | 1.0 | 0.46 |
| Chronic kidney disease | 13 | 2.8 | 2.4 | 0.60 |
| Maternal death | 14 | 3.3 | 2.4 | 0.81 |
| Intensive care unit admission | 191 | 41.0 | 35.9 | 0.24 |
| Dialysis | 44 | 10.4 | 7.6 | 0.21 |
*Test for linear trend in proportions based on each year between 2003 and 2010.
†Subcategories include women with more than one subtype of non-atonic postpartum haemorrhage.
‡Proportion calculated excludes women with missing information for parity (22% of deliveries).