Monitoring of postpartum haemorrhage through current information flows in Trentino Region, Italy

Objective. Postpartum haemorrhage (PPH) is the leading cause of maternal mortality and severe morbidity worldwide. Primary postpartum haemorrhage for spontaneous deliveries is defined as the loss of more than 500 mL of blood within 24 hours of childbirth, whereas for caesarean deliveries, it is considered as loss of more than 1,000 mL of blood. The objective is monitoring the risk of PPH in Trentino Region (North-East Italy). Materials and Methods. The distribution of primary PPH was analysed for the two types of delivery in terms of maternity facility characteristics, mother’s characteristics, labour and delivery characteristics. Event outcomes for the mother were also analysed (hospitalization, hysterectomy, blood product transfusions and fatality). Results. In the 2011-2016 period, there were 27.460 deliveries in the maternity facilities of Trentino region with an average overall prevalence of primary PPH of approximately 15%. The multivariate logistic regression analysis identified the significant independent predictors of primary PPH were age and nationality of the mother, parity, gestational age, medically assisted procreation, multiple births, neonatal weight, pregestational Body Mass Index, type of labour, maternal health concerns during pregnancy and tears and/or episiotomy. Conclusions. A PPH monitoring system using integrated current information flows could help the local health service and sector professionals to keep the phenomenon under control and monitor the quality of clinical practice.