Emotional impact of severe post-partum haemorrhage on women and their partners: an observational, case-matched, prospective, single-centre pilot study

Ricbourg, Aude; Gosme, Christelle; Gayat, Étienne; Ventré, Chloé; Barranger, Emmanuel; Mebazaa, Alexandre

doi:10.1016/j.ejogrb.2015.07.020

Cited by 34 publications

(54 citation statements)

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“…In the office, patient counseling could increase awareness of potential complications at time of delivery. In addition, setting patient expectations and allowing opportunities for providers to answer questions could potentially increase patient preparedness and decrease the emotional trauma that is commonly associated with sentinel maternal events like massive hemorrhage[26]. Our risk calculator using the key antepartum and intrapartum factors can be found on https://www.gwdocs.com/mfm/peripartum-prediction-of-blood-transfusion.…”

Section: Discussionmentioning

confidence: 99%

Predicting peripartum blood transfusion in women undergoing cesarean delivery: A risk prediction model

et al. 2018

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ObjectiveThere has been an appreciable rise in postpartum hemorrhage requiring blood transfusions in the United States. Our objective is to better define patients at greatest risk for peripartum transfusion at the time of cesarean in order to identify cases for early intervention and monitoring.MethodsOur study is a secondary analysis of a retrospective cohort study. Cases of intraoperative and immediate postpartum blood transfusion among women undergoing cesarean delivery were identified. Multivariable logistic regression models were used to identify antepartum and intrapartum risk factors that were independently associated with blood transfusion. A risk calculator was then developed to predict the need for transfusion.ResultsOf 56,967 women, 1488 (2.6%) required any blood transfusion. The strongest risk factors for peripartum blood transfusion included anemia (odds ratio [OR] 3.7, 95% CI 3.3–4.3), abruption on presentation (OR 3.3, CI 2.6–4.1), general anesthesia (OR 5.2, CI 4.4–6.1) and abnormal placentation (OR 92.0, CI 57.4–147.6). An antepartum (model 1) and combined antepartum plus intrapartum risk model (model 2) were developed (model 1 AUC = 0.77, model 2 AUC = 0.83) and internally validated.ConclusionsAmong women who required cesarean delivery, we were able to identify risk factors which predispose women to peripartum blood transfusion and developed a prediction model with good discrimination.

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Section: Discussionmentioning

confidence: 99%

Predicting peripartum blood transfusion in women undergoing cesarean delivery: A risk prediction model

et al. 2018

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“…Apart from the understanding about PPH causes and consequences, other factors that matter to beneficiaries in connection with prevention of PPH include avoidance of “heavy activities”, and the prevention of psychological distress associated with unsupportive partners. The emotional impact of PPH is sometimes not given much consideration in the literature but research suggests that, for some women, the repercussions can be severe and associated with long-term mental health problems including posttraumatic stress disorder [ 39 ]. Beneficiaries reported a barrier of living with low socioeconomic conditions which sometimes lead to delay in accessing health facilities.…”

Section: Discussionmentioning

confidence: 99%

Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives

Bazirete

Nzayirambaho

Umubyeyi

et al. 2020

BMC Pregnancy Childbirth

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Background Reduction of maternal mortality and morbidity is a major global health priority. However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for prevention of PPH and early detection of childbearing women at risk as perceived by beneficiaries and health workers in the Northern Province of Rwanda. Methods A qualitative descriptive exploratory study was drawn from a larger sequential exploratory-mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives (2 focus groups), community health workers (CHWs) in charge of maternal health (2 focus groups) and health care providers (3 focus groups). A socio ecological model was used to develop interview guides describing factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results We generated four interrelated themes: (1) Meaning of PPH: beliefs, knowledge and understanding of PPH: (2) Organizational factors; (3) Caring and family involvement and (4) Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. Involvement of all levels of the health system was recommended for a proactive prevention of PPH. Further quantitative research, using case control design is warranted to develop a screening tool for early detection of PPH risk factors for a proactive prevention.

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“…Apart from understanding about PPH, other factors that matter to bene ciaries in connection with prevention of PPH include avoidance of "heavy activities", and the prevention of psychological distress associated with unsupportive partners. The emotional impact of a PPH is sometimes not given much consideration in the literature but research suggests that, for some women, the repercussions can be severe and associated with long-term mental health problems including posttraumatic stress disorder [41]. Bene ciaries reported a barrier of living with low socioeconomic conditions which sometimes lead to delay in accessing health facilities.…”

Section: Bene Ciary Perspectivesmentioning

confidence: 99%

Influencing Factors for Early Detection and Prevention of Postpartum Hemorrhage in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives.

Bazirete

Nzayirambaho

Umubyeyi

et al. 2020

Preprint

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Background: Reduction of maternal mortality and morbidity is a major global health priority.However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for early detection and prevention of PPH as perceived by beneficiaries and health workers in the Northern Province of Rwanda. Methods: A qualitative descriptive exploratory study was drawn from a larger sequential exploratory‐mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives, community health workers (CHWs) in charge of maternal health and health care providers . A socio ecological model was used to develop interview guides to describe factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results: We generated four interrelated themes:Meaning of PPH: beliefs, knowledge and understanding of PPH:Organizational factors; Caring and family involvement and Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions: Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. A further case control study is warranted to develop a screening tool for early detection predictors to PPH.

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Emotional impact of severe post-partum haemorrhage on women and their partners: an observational, case-matched, prospective, single-centre pilot study

Cited by 34 publications

References 10 publications

Predicting peripartum blood transfusion in women undergoing cesarean delivery: A risk prediction model

Predicting peripartum blood transfusion in women undergoing cesarean delivery: A risk prediction model

Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives

Influencing Factors for Early Detection and Prevention of Postpartum Hemorrhage in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives.

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