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TOPLINE:

Women with polyhydramnios faced a higher risk for postpartum haemorrhage (PPH), with caesarean section delivery and foetal macrosomia serving as independent risk factors and prophylactic oxytocin use offering protection.

METHODOLOGY:

• This retrospective single-centre study (2015-2022) aimed to identify risk factors for PPH among pregnancies with polyhydramnios, focusing on uterine overdistension and higher caesarean rates.
• Overall, 387 women (mean age, 31.8 years) with singleton polyhydramnios pregnancies (≥ 32 weeks of gestation).
• Maternal, gestational, and delivery variables were collected, and women were grouped on the basis of the occurrence of PPH (genital blood loss ≥ 500 mL).
• The mode of delivery, prophylactic oxytocin use, macrosomia (birth weight ≥ 4000 g), and amnioreduction were analysed.
• The primary outcome was the incidence of PPH; secondary outcomes included the diagnosis timing of polyhydramnios differentiated between acute and chronic cases.

TAKEAWAY:

• PPH occurred in 8.0% of pregnancies with polyhydramnios vs 5.1% of those without (P = .01).
• Caesarean section delivery was an independent risk factor for PPH (odds ratio [OR], 2.6; P = .03); the caesarean section rate in women with polyhydramnios was significantly higher than that in the general population from France (45% vs 21.4%).
• Foetal macrosomia was associated with an increased risk for PPH (OR, 2.8; P = .04).
• Prophylactic oxytocin use led to a significant reduction in the risk for PPH (OR, 0.1; P < .01); missed doses were four times higher in women with PPH than in those without (9.7% vs 2.3%; P < .05).

IN PRACTICE:

"In cases of polyhydramnios, caesarean section and the absence of prophylactic oxytocin administration are risk factors for PPH," the authors of the study wrote.

SOURCE:

This study was led by Camille Leclerc, Department of Obstetrics and Gynaecology, Charles Nicolle University Hospital, Rouen, France. It was published online on April 19, 2025, in the Journal of Gynecology Obstetrics and Human Reproduction.

LIMITATIONS:

The study's retrospective design may have introduced information biases; the single-centre study design limited the generalisability of the findings; and a small sample size was insufficient to analyse PPH severity subgroups.

DISCLOSURES:

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.