Oxytocin · research summary

Categorizing differences in postpartum hemorrhage management and associated clinical factors.

Pregnancy (Hoboken, N.J.) · 2026. Summary drawn from the study's full text. Each statement is followed by the exact sentence it comes from. This is a research summary, not medical advice.

Study type

Retrospective cohort study
“This is a retrospective cohort study of patients delivered at ≥20 weeks of gestation at any of four hospitals within one Connecticut healthcare system, with evidence of PPH, and receipt of intervention from 2012 to 2023.”

Subjects

Patients with documented postpartum hemorrhage delivered at four hospitals in a Connecticut healthcare system, excluding those with placenta accreta spectrum disorders, obstetric anal sphincter injuries, or stillbirth
“Patients with placenta accreta spectrum disorders, obstetric anal sphincter injuries, or stillbirth were excluded.”

Sample size

10,075 delivery encounters
“Of these deliveries, 10,075 (93.0%) met eligibility criteria and were included in the analysis”

Duration

April 2012 through January 2023
“The study period was from April 2012, when the EMR system was introduced, through January 2023.”

Reported findings

Significant variation exists in postpartum hemorrhage management types across the cohort
“There is significant variation in the management of PPH, and differences are associated with patient‐level factors and delivery hospital type and region, which may be a proxy for clinical management and available resources.”
Patient-level factors such as age, race, gestational age, and specific conditions are associated with different types of PPH management
“Adjusted multinomial logistic regression analyses showed significant differences in patient‐level factors (e.g., maternal age, race and ethnicity, gestational age, placenta previa, hypertensive disorders, and in vitro fertilization [IVF]) and delivery hospital among different types of PPH management.”
ICU admission frequencies increased with more complex and invasive treatment categories
“The frequencies of ICU admission were significantly increased in treatment categories with more complexity and invasiveness (p < 0.001): usual care treatment (57/4941 [1.2%]); less aggressive medication treatment (42/2982 [1.4%]); more aggressive medication treatment (30/1308 [2.3%]; and procedures with and without medications (74/844 [8.8%]).”

Limitations stated by the authors

Potential inaccuracies in PPH case identification due to ICD code limitations and estimated blood loss reliability; inability to assess vital sign data or rare outcomes like severe maternal mortality; and limited generalizability due to the single health system setting
“First, while we attempted to identify all true cases of PPH using comprehensive criteria, some defined cases may be inaccurate or inconsistent. This is because ICD codes have inherent limitations [22], EBL can be unreliable [1], and there may be cases of postpartum blood transfusions given for other indications (e.g., sickle cell disease) rather than acute blood loss anemia.”

Source: PubMed 42846915 · DOI 10.1002/pmf2.70483 · all study summaries

Subjects

Patients with documented postpartum hemorrhage delivered at four hospitals in a Connecticut healthcare system, excluding those with placenta accreta spectrum disorders, obstetric anal sphincter injuries, or stillbirth

“Patients with placenta accreta spectrum disorders, obstetric anal sphincter injuries, or stillbirth were excluded.”

Reported findings

Significant variation exists in postpartum hemorrhage management types across the cohort

“There is significant variation in the management of PPH, and differences are associated with patient‐level factors and delivery hospital type and region, which may be a proxy for clinical management and available resources.”

Patient-level factors such as age, race, gestational age, and specific conditions are associated with different types of PPH management

“Adjusted multinomial logistic regression analyses showed significant differences in patient‐level factors (e.g., maternal age, race and ethnicity, gestational age, placenta previa, hypertensive disorders, and in vitro fertilization [IVF]) and delivery hospital among different types of PPH management.”

ICU admission frequencies increased with more complex and invasive treatment categories

“The frequencies of ICU admission were significantly increased in treatment categories with more complexity and invasiveness (p < 0.001): usual care treatment (57/4941 [1.2%]); less aggressive medication treatment (42/2982 [1.4%]); more aggressive medication treatment (30/1308 [2.3%]; and procedures with and without medications (74/844 [8.8%]).”

Limitations stated by the authors

Potential inaccuracies in PPH case identification due to ICD code limitations and estimated blood loss reliability; inability to assess vital sign data or rare outcomes like severe maternal mortality; and limited generalizability due to the single health system setting

“First, while we attempted to identify all true cases of PPH using comprehensive criteria, some defined cases may be inaccurate or inconsistent. This is because ICD codes have inherent limitations [22], EBL can be unreliable [1], and there may be cases of postpartum blood transfusions given for other indications (e.g., sickle cell disease) rather than acute blood loss anemia.”