{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:55:07Z","timestamp":1785488107572,"version":"3.56.0"},"reference-count":26,"publisher":"Walter de Gruyter GmbH","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0165_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare a composite hemorrhage-related maternal morbidity in individuals with secondary to primary postpartum hemorrhage and treatment interventions utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0165_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case-control study of deliveries complicated by secondary postpartum hemorrhage was performed at a tertiary care center. To estimate a clinically relevant increase of 50\u202f% in the composite maternal hemorrhage-related maternal morbidity (35\u201353\u202f% absolute increase) in individuals with secondary postpartum hemorrhage, a correlation coefficient of 0.2, at an 80\u202f% power with a p\u202f&lt;\u202f0.05 with a two-sided test would require 95 individuals with secondary postpartum hemorrhage be matched to 95 individuals with a primary postpartum hemorrhage. Logistic regression analysis was used to evaluate the outcome of the composite of hemorrhage-related maternal morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0165_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From January 2018 through December 2022, 33,026 deliveries occurred, and 94 individuals were identified that were admitted with secondary postpartum hemorrhage, 0.28\u202f% of deliveries, 95\u202f% confidence interval (CI) 0.21\u20130.35\u202f%. The composite hemorrhage-related maternal morbidity was increased in individuals with secondary compared to primary postpartum hemorrhage, adjusted odds ratio (OR) 14.0, 95\u202f% CI 4.6 to 42.2. Most individuals with secondary postpartum hemorrhage had a dilation and curettage 91.5\u202f% (86\/94). In individuals with secondary postpartum hemorrhage that underwent uterine evacuation, histology revealed 45.2\u202f% (38\/84) had retained placenta, and 20.2\u202f% (17\/84) subinvolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0165_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A composite maternal hemorrhage-related outcome is associated more often with secondary compared to primary postpartum hemorrhage and nearly all individuals with secondary postpartum hemorrhage undergo a dilation and curettage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0165","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T16:11:23Z","timestamp":1758211883000},"page":"1208-1215","source":"Crossref","is-referenced-by-count":2,"title":["Hemorrhage-related maternal morbidity of secondary compared to primary postpartum hemorrhage"],"prefix":"10.1515","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3393-9124","authenticated-orcid":false,"given":"Matthew R.","family":"Carroll","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology , 3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7038-8616","authenticated-orcid":false,"given":"Sarah","family":"Tounsi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , 3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0363-8216","authenticated-orcid":false,"given":"Jessica L.","family":"Gerard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , 3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5164-3273","authenticated-orcid":false,"given":"Susan M.","family":"Leong-Kee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , 3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8243-793X","authenticated-orcid":false,"given":"Laurie S.","family":"Swaim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , 3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3909-3131","authenticated-orcid":false,"given":"Mark A.","family":"Turrentine","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , 3989 Baylor College of Medicine , Houston , TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"2025121815535107170_j_jpm-2025-0165_ref_001","unstructured":"Centers for Disease Control and Prevention. 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