{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:16:58Z","timestamp":1789834618333,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T00:00:00Z","timestamp":1428883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The principal objective of our study was to describe the frequency of severe secondary postpartum hemorrhages (<jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content>). Our secondary objectives were to describe the different causes of PPH and to assess if the PPH etiologies varied by parity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a historical cohort study covering the period from January 1, 2004, through February 13, 2013, in a level <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> maternity ward. Women were eligible if they were treated for severe secondary <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> during their postpartum hospitalization or were admitted for it after discharge but before the 42nd day postpartum, regardless of the type of delivery. Women were excluded if they gave birth before 22\u00a0weeks of gestation or if they had experienced only an immediate <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> (\u2264\u00a024\u00a0hours after delivery). Eligible patients were identified by the hospital's administrative software. Primiparas and multiparas were compared with Student's <jats:italic>t<\/jats:italic> test and a chi\u2010squared or Fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of severe secondary <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> was 0.23 percent (<jats:italic>n<\/jats:italic>\u00a0=\u00a060\/26,023). The mean time between delivery and <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> onset was 13.4\u00a0\u00b1\u00a010.8\u00a0days. The women's mean age was 30.4\u00a0\u00b1\u00a05.7\u00a0years and their mean body mass index was 23.4\u00a0\u00b1\u00a05.7\u00a0kg\/m\u00b2. Placental retention was the cause to which these hemorrhages were most frequently attributed (30.0%). Subinvolution of the placental bed was noted in 13.3 percent of the patients, endometritis in 10.0 percent, pseudoaneurysm of the uterine artery in 3.3 percent, and excessively strong resumption of menses in 3.3 percent; no cause could be determined for 16.7 percent of the cases. Neither clinical signs nor causes differed by parity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Secondary <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> is rare. Accurate diagnosis is based most often on histopathologic findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12164","type":"journal-article","created":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T11:45:11Z","timestamp":1428925511000},"page":"149-155","source":"Crossref","is-referenced-by-count":63,"title":["Severe Secondary Postpartum Hemorrhage: A Historical Cohort"],"prefix":"10.1111","volume":"42","author":[{"given":"Mathieu","family":"Dossou","sequence":"first","affiliation":[{"name":"EA 4681, PEPRADE University of Auvergne Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Debost\u2010Legrand","sequence":"additional","affiliation":[{"name":"Department of Public Health Clermont\u2010Ferrand University Hospital Center Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"D\u00e9chelotte","sequence":"additional","affiliation":[{"name":"Department of Fetal Pathology University Hospital Center Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"L\u00e9mery","sequence":"additional","affiliation":[{"name":"EA 4681, PEPRADE University of Auvergne Clermont\u2010Ferrand France"},{"name":"Department of Obstetrics &amp; Gynecology Clermont\u2010Ferrand University Hospital Center Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Vendittelli","sequence":"additional","affiliation":[{"name":"EA 4681, PEPRADE University of Auvergne Clermont\u2010Ferrand France"},{"name":"Department of Public Health Department of Obstetrics &amp; Gynecology Clermont\u2010Ferrand University Hospital Center Clermont\u2010Ferrand France"},{"name":"AUDIPOG Sentinel Network Medical university RTH Laennec Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1987.tb02255.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1966.tb05120.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1989.tb01776.x"},{"issue":"1","key":"e_1_2_7_5_1","first-page":"17","article-title":"Delayed postpartum hemorrhage: A morphologic study of causes and their relation to other pregnancy disorders","volume":"82","author":"Khong TY","year":"1993","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2006.00743.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1989.tb01591.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.07.029"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767059509017290"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443619609030085"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00230.x"},{"key":"e_1_2_7_12_1","first-page":"713","article-title":"Subinvolution of the placental site","volume":"37","author":"Ober WB","year":"1961","journal-title":"Bull N Y Acad Med"},{"issue":"10","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.5858\/2006-130-1538-SOTPSA","article-title":"Subinvolution of the placental site as an anatomic cause of postpartum uterine bleeding: A review","volume":"130","author":"Weydert JA","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610120113238"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00636.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340902934670"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340903093559"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2012.07.002"},{"key":"e_1_2_7_19_1","unstructured":"Association des Utilisateurs de Dossiers Informatis\u00e9s en P\u00e9diatrie Obst\u00e9trique et Gyn\u00e9cologie. 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