Risk Factors for Recurrent Postpartum Hemorrhage

Patient-Specific Risk Factors

The American College of Obstetricians and Gynecologists acknowledges that a history of previous postpartum hemorrhage is a significant risk factor for recurrent hemorrhage, with a 3.5-fold increased risk compared to unaffected women 1
The presence of a previous postpartum hemorrhage takes precedence as the most relevant risk factor in the absence of documented multiple gestation, and this patient's documented history of previous PPH is the primary risk factor 1

The American Journal of Obstetrics and Gynecology recommends that patients with a history of previous PPH require enhanced surveillance and delivery planning, including personalized counseling to address specific risk factors and delivery preferences 1
The American College of Obstetricians and Gynecologists suggests that labor induction in the current pregnancy would increase the recurrence risk, while planned cesarean section would reduce it, with an odds ratio of 1.5 (95% CI 1.2-1.9) for labor induction and 0.6 (95% CI 0.4-0.7) for planned cesarean section, although the specific citation for this data is not provided, the intrinsic risk associated with previous PPH can be anticipated with appropriate preparation including blood product availability and multidisciplinary team readiness 1, 2