TABLE 2.
Incidence of PPH by labor and birth characteristics, United States community births, 2004–2009
| Variable | n (%) | PPH over 500 mL, n (%) | PPH 1000 mL or greater, n (%) |
|---|---|---|---|
| Induction | 2267 (12.7) | 459 (20.4%)*** | 107 (4.8)*** |
| No Induction | 15 567 (87.3) | 2363 (15.3) | 478 (3.1) |
| Augmentation | 1414 (7.93) | 280 (19.8)*** | 59 (4.2)* |
| No augmentation (spontaneous labors) | 14 153 (90.9) | 2083 (14.8) | 419 (2.9) |
| Water birth | 6364 (35.7) | 858 (13.5)*** | 175 (2.7)*** |
| Land birth | 11 463 (64.3) | 1965 (17.2) | 411 (3.6) |
| Artificial rupture of membranes | |||
| Before 5 cm | 210 (1.2) | 32 (15.3) | 6 (2.9) |
| 5 cm or greater | 1005 (5.6) | 185 (18.4)* | 35 (3.5) |
| Duration of rupture of membranes | |||
| Less than 1 h | 8658 (50.6) | 1144 (13.3)*** | 210 (2.4)*** |
| Up to 12 h | 6693 (39.1) | 1210 (18.1) | 261 (3.9) |
| ≥12 h | 1764 (10.3) | 364 (20.7) | 90 (5.1) |
| Duration of (Latent) first stage | |||
| <18 h | 15 450 (87.9) | 2366 (15.4)*** | 494 (3.2) |
| ≥18 h | 2132 (12.1) | 418 (19.7) | 80 (3.8) |
| Duration of (active) first stage | |||
| 0–6 h | 12 852 (72.3) | 1831 (14.3)*** | 367 (2.9)*** |
| 6.1–12 h | 3869 (21.8) | 719 (18.7) | 160 (4.2) |
| >12 h | 1064 (5.9) | 266 (25.0) | 58 (4.5) |
| Duration of second stage | |||
| Up to 30 min | 10 655 (60.1) | 1331 (12.5)*** | 251 (2.4)*** |
| 31–60 min | 3127 (17.6) | 552 (17.7) | 122 (3.9) |
| >1 h and <5 h | 3712 (20.9) | 876 (23.6) | 202 (5.4) |
| 5+ hours | 233 (1.3) | 61 (27.4) | 11 (4.9) |
| Perineal trauma | |||
| None | 8753 (49.4) | 1091 (12.5)*** | 210 (2.4)*** |
| Single/minor repair | 6650 (37.4) | 1172 (17.7) | 235 (3.6) |
| 3rd/4th or major (cervical/sulcus) | 378 (2.1) | 93 (24.7) | 26 (6.9) |
| Multiple sites of trauma | 1974 (11.1) | 455 (23.2) | 110 (5.6) |
| Length of third stage | |||
| <15 min | 8585 (48.3) | 1371 (16.0)*** | 250 (2.9)*** |
| 15–29 min | 6065 (34.1) | 899 (14.9) | 185 (3.1) |
| 30–59 min | 2526 (14.2) | 355 (14.1) | 68 (2.7) |
| ≥60 min | 607 (3.4) | 181 (30.1) | 78 (12.9) |
| Manual removal of placenta | 239 (1.3) | 143 (60.3)*** | 69 (29.1)*** |
| Spontaneous placenta | 17 583 (98.7) | 2678 (15.3) | 517 (2.9) |
| PPH prevention strategy/action | |||
| None | 14 852 (83.3) | 1957 (13.2)*** | 456 (2.7)*** |
| Oxytocin/methergine | 1114 (6.3) | 413 (37.5)*** | 130 (11.8)*** |
| Herbal preparation | 1296 (7.3) | 368 (28.5)*** | 103 (7.9)*** |
| Others | 927 (5.2) | 222 (24.0)*** | 60 (6.5)*** |
| Postpartum anemia | 193 (1.1) | 157 (82.6)*** | 93 (48.9)*** |
Abbreviations: cm, centimeters; PPH, postpartum hemorrhage.
*
P < .05,
**
P < .01,
***
P < .001.
chi-square test.