[Risk factors of evolution of postpartum XXXX towards severe postpartum @entity548 : A case-control study].

@entity1 @entity10464 @entity101 @entity548
OBJECTIVE: To describe the incidence and risk factors for evolution of postpartum @entity548 towards severe. MATERIAL AND METHODS: Epidemiologic, observational, analytical, case-control study was done from total data of deliveries in Complexo Hospitalario de Our  nse between January 1st 2004 and June 30th 2014. Mann-Whitney U test was used to determine the differences between cases and controls. The statistical analyses were made with the informatic programs Spss 15.0 y Epidat 3.0. We considered statistical significance for p < 0.05. RESULTS: The initial size of the sample was 17,116 deliveries from which we selected 150 @entity1 with the diagnosis of postpartum @entity548 . The incidence for @entity10464 form all deliveries was 3.3% reaching 36% of the total of postpartum @entity548 . 79.63% of @entity10464 showed symptoms withing the first 24h postpartum, but we found that 20.37% debuted as secondary postpartum @entity548 . BMI >=  35, @entity101 gestational manifestations, labor's second phase >=  120 minutes and weight at birth > 4000 g presented statistical significance as risk factor for evolution to severe postpartum haemhorrage. The relative risk for evolution towards @entity10464 was 2.81 for instrumental delivery and 3.55 for cesarean section. The most prevalent etiology was uterine atony. CONCLUSION: The incidence of @entity10464 in our hospital is low, as well as secondary maternal mortality. The major risk factor for the appearance of the clinical symptoms is cesarean section, followed, in less proportion by instrumental delivery. It is possible for the @entity10464 to make its appearance delayed after delivery, usually secondary to infrequent and non well-known clinical presentations.
