OBJECTIVE: To determine the incidence, risk factors, presentation, treatment and morbidity associated with secondary postpartum @entity548 . DESIGN: Analysis of 132 consecutive @entity1 presenting with secondary postpartum @entity548 occurring over a three-year period. SETTING: The maternity unit in a district general teaching hospital serving an annual delivery rate of around 6500 @entity1 . MAIN OUTCOME MEASURES: Factors associated with the cause of the @entity548 and the resulting morbidity. RESULTS: Most @entity1 presented during the second week after delivery. A history of primary postpartum @entity548 (OR 9.3; 95% CI 6.2-14.0) and manual removal of placenta (OR 3.5; 95% CI 1.6-7.5) were the only significant risk factors identified. There was a high associated morbidity, with 84% requiring hospital admission, 63% surgical evacuation, 17% blood transfusion, with three @entity1 suffering a uterine perforation, one managed by hysterectomy. In @entity1 undergoing evacuation only, 37% had retained placental tissue confirmed after surgery; pre-operative ultrasound examination did not provide a better discrimination over clinical assessment for this finding. CONCLUSIONS: Secondary postpartum @entity548 occurs in just under 1% of @entity1 , is associated with primary postpartum @entity548 and @entity1268 , and may result in significant maternal morbidity. This problem deserves more attention than it has received in recent years.

Secondary postpartum XXXX : incidence, morbidity and current management.

@entity1 :: ('9606', 'Species') :: ['women'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhage'] @entity1268 :: ('MESH:D018457', 'Disease') :: ['retained placenta']
@entity548 :: (MESH:D006470,Disease) :: ['haemorrhage']
