Trial reportInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2019
Secondary analysis of the WOMAN trial to explore the risk of sepsis after invasive treatments for postpartum hemorrhage.
Trial report in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Effectiveness of uterine tamponade devices for refractory postpartum haemorrhage after vaginal birth: a systematic review.BJOG : an international journal of obstetrics and gynaecology · 2021Pooled it
- Trial
- Incidence and risk factors for postpartum infections: A Norwegian cohort study, 2012-2020.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Factors influencing health promotion behavior on puerperal sepsis among postpartum mothers.BMC pregnancy and childbirth · 2025Article
- Postpartum Haemorrhage and Long-Term Mortality.Paediatric and perinatal epidemiology · 2025Article
- Antimicrobial stewardship and targeted therapies in the changing landscape of maternal sepsis.Journal of intensive medicine · 2024Review
- Infection-related severe maternal outcomes and case fatality rates in 43 low and middle-income countries across the WHO regions: Results from the Global Maternal Sepsis Study (GLOSS).PLOS global public health · 2024Article
- Effect of Baogong Zhixue Granules Combined with Tranexamic Acid Injection on the Hemodynamics and Reproductive System in Patients with Postpartum Hemorrhage after Cesarean Section.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study.The Lancet. Global health · 2020Article
- Sepsis: Precision-Based Medicine for Pregnancy and the Puerperium.International journal of molecular sciences · 2019Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 5 countries.
Funding
Abstract
objectiveTo examine the association between the use of invasive treatments for postpartum hemorrhage and the risk of sepsis and severe sepsis.
methodsSecondary data analysis of the WOMAN randomized controlled trial, including 20 060 women with postpartum hemorrhage in 21 countries. Logistic regression with random effects was used.
resultsThe cumulative incidence was 1.8% for sepsis and 0.5% for severe sepsis. All-cause mortality was 40.4% in women with severe sepsis versus 2.2% for women without. After adjusting for bleeding severity and other confounders, intrauterine tamponade, hysterectomy, and laparotomy increased the risk of sepsis (aOR 1.77 [95% CI 1.21-2.59], P=0.004; aOR 1.97 [95% CI 1.49-2.65], P<0.001; and aOR 6.63 [95% CI 4.29-10.24], P<0.001, respectively) and severe sepsis (aOR 2.60 [95% CI 1.47-4.59], P=0.002; aOR 1.97 [95% CI 0.83-2.46], P=0.033; and aOR 5.35 [95% CI 2.61-10.98], P<0.001, respectively).
conclusionIn this secondary data analysis, certain invasive treatments for postpartum hemorrhage appear to increase the risk of sepsis. Further research is needed to confirm this finding and investigate the role of prophylactic antibiotics during these procedures. The harms and benefits of such interventions must be carefully weighed, both in treatment guidelines and during individual patient management.
trial registrationISRCTN76912190.
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Registered trials
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