The EACD contributed safely and effectively to the treatment of 60 women with PPH of different causes.

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M. Ibrahim). OBJECTIVE:To determine the impact of maternal body mass index (BMI) on the risk of developing primary postpartum haemorrhage (PPH).METHOD: Retrospective population based study in a single obstetric unit in regional New South Wales, Australia for the period 1 January 2006 to 31 December 2015. Singleton pregnancies above 34 weeks gestation were included in the study. Data was collected from antenatal, hospital discharge and birthing records. Primary exclusion criteria were prematurity (<34 weeks), multiple gestation and incomplete records. Women were categorized according to World Health Organization BMI classification into: underweight (BMI < 18.50), normal weight (BMI 18.50-24.99), pre-obese (BMI 25.00-29.99) and obese (BMI ≥ 30). The primary outcome studied was primary PPH (estimated blood loss of ≥ 500 ml within the first 24 hours of delivery). Subgroup analysis was performed on total volume of blood loss, mode of delivery and parity.RESULTS: Of the 14,935 mothers included in the study, 10,953 had vaginal births and 3982 had caesarean sections. Nulliparous women represented 37% of vaginal deliveries and 41% of caesarean sections. The odds ratio for PPH for pre-obese and obese women compared to normal weight nulliparous women was 1.28 (95% CI 1.05-1.57) p = 0.0155 and 1.24 (1.02-1.51) p = 0.0349 respectively. For multiparous women the odds ratio was 1.32 (95% CI 1.15-1.52) p = 0.0001 and 1.33 (95% CI 1.16-1.52) p < 0.0001 respectively. Subgroup analysis of vaginal deliveries demonstrate an odds ratio for PPH in nulliparous women of 1.08 (95% CI 0.87-1.34) p = 0.4852 for pre-obese and 1.15 (95% CI 0.92-1.44) p = 0.2157 for obese. For multiparous women, the odds ratio was 1.28 (95% CI 1.05-1.57) p = 0.0155 for pre-obese and 1.24 (95% CI 1.02-1.51) p = 0.0340 for obese.CONCLUSION: Pre-obese and obese women are at a significantly increased risk of PPH compared to women of normal weight (between 16-54%) when data is pooled for mode of delivery. This relationship was maintained at the level of the sub-group analysis between multiparous and nulliparous women. These findings emphasise the need for active management of third stage labour in pre-obese and obese women. http://dx.

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