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Identifying the risk: a prospective cohort study examining postpartum haemorrhage in a regional Australian health service

Overview of attention for article published in BMC Pregnancy and Childbirth, June 2018
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Title
Identifying the risk: a prospective cohort study examining postpartum haemorrhage in a regional Australian health service
Published in
BMC Pregnancy and Childbirth, June 2018
DOI 10.1186/s12884-018-1852-8
Pubmed ID
Authors

Lauren Kearney, Mary Kynn, Rachel Reed, Lisa Davenport, Jeanine Young, Keppel Schafer

Abstract

In industrialised countries the incidence of postpartum haemorrhage (PPH) is increasing, for which exact etiology is not well understood. Studies have relied upon retrospective data with estimated blood loss as the primary outcome, known to be underestimated by clinicians. This study aimed to explore variables associated with PPH in a cohort of women birthing vaginally in coastal Queensland, Australia, using the gravimetric method to measure blood loss. Women were prospectively recruited to participate using an opt-out consent process. Maternal demographics; pregnancy history; model of care; mode of birth; third stage management practices; antenatal, intrapartum and immediate postpartum complications; gravimetric and estimated blood loss; and haematological laboratory data, were collected via a pre-designed data collection instrument. Descriptive statistics were used for demographic, intrapartum and birthing practices. A General Linear Model was used for multivariate analysis to examine relationship between gravimetric blood loss and demographic, birthing practices and intrapartum variables. The primary outcome was a postpartum haemorrhage (blood loss > 500 ml). 522 singleton births were included in the analysis. Maternal mean age was 29 years; 58% were multiparous. Most participants received active (291, 55.7%) or modified active management of third stage (191, 36.6%). Of 451 births with valid gravimetric blood loss recorded, 35% (n = 159) recorded a loss of 500 ml or more and 111 (70%) of these were recorded as PPH. Gravimetric blood loss was strongly correlated with estimated blood loss (r = 0.88; p < 0.001). On average, the estimated blood loss was lower than the gravimetric blood loss, about 78% of the measured value. High neonatal weight, perineal injury, complications during labour, separation of mother and baby, and observation of a gush of blood were associated with PPH. Nulliparity, labour induction and augmentation, syntocinon use were not associated with PPH. In contrast to previous study findings, nulliparity, labour induction and augmentation were not associated with PPH. Estimation of blood loss was relatively accurate in comparison to gravimetric assessment; raising questions about routine gravimetric assessment of blood loss following uncomplicated births. Further research is required to investigate type and speed of blood loss associated with PPH.

Mendeley readers

The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 66 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 12 18%
Student > Master 9 14%
Other 5 8%
Researcher 5 8%
Student > Ph. D. Student 5 8%
Other 11 17%
Unknown 19 29%
Readers by discipline Count As %
Medicine and Dentistry 16 24%
Nursing and Health Professions 15 23%
Engineering 3 5%
Immunology and Microbiology 2 3%
Social Sciences 2 3%
Other 8 12%
Unknown 20 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 June 2018.
All research outputs
#9,592,250
of 15,077,469 outputs
Outputs from BMC Pregnancy and Childbirth
#2,103
of 2,787 outputs
Outputs of similar age
#166,528
of 277,559 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#1
of 1 outputs
Altmetric has tracked 15,077,469 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,787 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 17th percentile – i.e., 17% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,559 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them