{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:34:01Z","timestamp":1791635641226,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T00:00:00Z","timestamp":1415232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T00:00:00Z","timestamp":1415232000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":299,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008968","name":"National Research Council Sri Lanka","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003631","name":"National Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003631","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Science and Technology of the Brazilian Ministry of Health","award":["402702\/2008-5"],"award-info":[{"award-number":["402702\/2008-5"]}]},{"DOI":"10.13039\/100008968","name":"National Research Council Sri Lanka","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008968","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Science and Technology of the Brazilian Ministry of Health","award":["402702\/2008-5"],"award-info":[{"award-number":["402702\/2008-5"]}]}],"content-domain":{"domain":["ijgo.org","clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the occurrence of severe maternal complications owing to postpartum hemorrhage (PPH) and its associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A secondary analysis of data from a multicenter cross\u2010sectional prospective surveillance study included 9555 cases of severe maternal morbidity at 27 centers in Brazil between July 2009 and June 2010. Complications of PPH, conditions of severity management, and sociodemographic and obstetric characteristics were assessed. Factors independently associated with severe maternal outcome (SMO) were identified using multiple regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 1192 (12.5%) of the 9555 women experienced complications owing to PPH (981 had potentially life\u2010threatening conditions, 181 maternal near miss, and 30 had died). The SMO ratio was 2.6 per 1000 live births among women with PPH and 8.5 per 1000 live births among women with other complications. Women with PPH had a higher risk of blood transfusion and return to the operating theater than did those with complications from other causes. Maternal age, length of pregnancy, previous uterine scar, and cesarean delivery were the main factors associated with an increased risk of SMO secondary to PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PPH frequently leads to severe maternal morbidity. A surveillance system can identify the main causes of morbidity and could help to improve care, especially among women identified as being at high risk of PPH.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2014.08.023","type":"journal-article","created":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T12:09:40Z","timestamp":1415275780000},"page":"131-136","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":39,"title":["Severe maternal morbidity and near miss due to postpartum hemorrhage in a national multicenter surveillance study"],"prefix":"10.1002","volume":"128","author":[{"given":"Edilberto A.","family":"Rocha Filho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria L.","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose G.","family":"Cecatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Parpinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira M.","family":"Haddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo C.","family":"Pacagnella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria H.","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Elias F.","family":"Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda G.","family":"Surita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao P.","family":"Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Brazilian Network for Surveillance of Severe Maternal Morbidity Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,6]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60686-8"},{"issue":"9726","key":"e_1_2_6_3_2","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1016\/S0140-6736(10)60518-1","article-title":"Maternal mortality for 181 countries, 1980\u20102008: a systematic analysis of progress towards Millennium Development Goal 5","volume":"375","author":"Hogan M.C.","year":"2010","journal-title":"Lancet"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3181cc406d"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822a6c59"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7294.1089"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34984-2"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12588"},{"key":"e_1_2_6_10_2","unstructured":"World Health Organization.WHO recommendations for the prevention and treatment of postpartum haemorrhage.http:\/\/apps.who.int\/iris\/bitstream\/10665\/75411\/1\/9789241548502_eng.pdf?ua=1 Published 2012. 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