Prevalence of Massive Postpartum Hemorrhage in Women with Obesity Following Delivery

Abstract

Background: The causes of maternal morbidity and mortality in the world are severe postpartum hemorrhage (PPH), and obesity has become the primary risk factor that influences the outcomes of pregnancies and childbirth. Obese women are more likely to develop uterine atony, cesarean birth, and present with comorbidities, such as hypertension and diabetes, which may be a risk factor for excessive blood loss. Purpose: The study objective was to determine the prevalence and predictors of severe postpartum bleeding among obese women following childbirth and raise concerns relating to the reliability and validity of the research instrument used in the measurement of the related perceptions and clinical risk factors. Methods: The hospital-based cross-sectional change was implemented, and 75participants participated. The data were collected by means of a structured questionnaire and a clinical observation sheet. Statistical tests included normality tests, t-test (reliability) of reliability (Cronbach's Alpha), and validity (Bartlett test), independent samples t-test, one-way ANOVA, Kruskal-Wallis test, Chi-Square test, correlation tests, and logistic regression. The loss of 1000ml of blood or more within 24 hours of delivery was taken to constitute severe PPH. Results: The normality test showed that the parametric tests are appropriate. Internal consistency of the questionnaire was excellent (Cronbach's Alpha = 0.874) and validity (KMO = 0.812; Bartlett p < 0.001). The independent samples t-test showed that women with severe PPH had significantly higher BMI and birth weight of the babies. The ANOVA and Kruskal-Wallis showed that the degree of blood loss was much higher in relation to the obese classes and mode of delivery, particularly when carrying out cesarean section. Chi-Square analysis established that the delivery mode and the severe incidence of PPH had a high correlation. The positive relationship between the BMI and the birthweight and the estimated blood loss was determined through the correlation analysis. The important positive predictors of severe PPH determined by logistic regression were BMI, cesarean delivery, instrumental delivery, birthweight, hypertension, and diabetes. Conclusion: Maternal obesity is a serious risk factor for acute perineal bleeding, which is aggravated by comorbid factors and cesarean section. The active treatment of the third phase of labor, transfusion preparation, and weight and comorbidity management during antenatal counseling are required. Individual interventions can be used to reduce the burden of severe PPH in obese women and achieve improved maternal outcomes.