ArticleBJOG : an international journal of obstetrics and gynaecology2020
Maternal characteristics and causes associated with refractory postpartum haemorrhage after vaginal birth: a secondary analysis of the WHO CHAMPION trial data.
Article in BJOG : an international journal of obstetrics and gynaecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Safety and Effectiveness of Uterine Gauze Packing for Refractory Postpartum Haemorrhage: A Systematic Review and Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2026Pooled it
- 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
- Prenatal anemia and postpartum hemorrhage risk: A systematic review and meta-analysis.The journal of obstetrics and gynaecology research · 2021Pooled it
- Vacuum-assisted hemorrhage control device versus uterine balloon tamponade for refractory atonic postpartum hemorrhage in a protocol-driven care pathway-A retrospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Development and validation of a postpartum hemorrhage risk prediction model for advanced maternal age women undergoing vaginal delivery: a comparison of multiple machine learning algorithms.Frontiers in medicine · 2026Article
- Management practices of primary postpartum hemorrhage among traditional birth attendants: a qualitative survey, Iganga, Uganda.African health sciences · 2025Article
- Cost analysis of intrauterine balloon tamponade versus uterine artery embolization in the management of persistent postpartum hemorrhage.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Evaluating predelivery platelet and coagulation indices as predictors of immediate postpartum haemorrhage in low-risk women undergoing vaginal delivery.BMC pregnancy and childbirth · 2025Article
- Response to risk of postpartum hemorrhage and fetal gender.Archives of gynecology and obstetrics · 2023Article
- Observational
- Oxytocin receptor DNA methylation is associated with exogenous oxytocin needs during parturition and postpartum hemorrhage.Communications medicine · 2023Article
- Review of Current Insights and Therapeutic Approaches for the Treatment of Refractory Postpartum Hemorrhage.International journal of women's health · 2023Review
- Oxytocin receptor single nucleotide polymorphism predicts atony-related postpartum hemorrhage.BMC pregnancy and childbirth · 2022Article
- Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study.PloS one · 2022Article
- Angiographic features and transarterial embolization of retained placenta with abnormal vaginal bleeding.CVIR endovascular · 2021Article
- Maternal characteristics and causes associated with refractory postpartum haemorrhage after vaginal birth: a secondary analysis of the WHO CHAMPION trial data.BJOG : an international journal of obstetrics and gynaecology · 2020Article
Corrections and comments
- Commented on by
Authors and funding
14 authors at 10 institutions in 10 countries.
Funding
Abstract
objectiveTo assess the maternal characteristics and causes associated with refractory postpartum haemorrhage (PPH).
designSecondary analysis of the WHO CHAMPION trial data.
settingTwenty-three hospitals in ten countries. POPULATION: Women from the CHAMPION trial who received uterotonics as first-line treatment of PPH.
methodsWe assessed the association between sociodemographic, pregnancy and childbirth factors and refractory PPH, and compared the causes of PPH between women with refractory PPH and women responsive to first-line PPH treatment.
main outcome measuresMaternal characteristics; causes of PPH.
resultsWomen with labour induced or augmented with uterotonics (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.72), with episiotomy or tears requiring suturing (aOR 1.82; 95% CI 1.34-2.48) and who had babies with birthweights ≥3500 g (aOR 1.33; 95% CI 1.04-1.69) showed significantly higher odds of refractory PPH compared with the reference categories in the multivariate analysis adjusted by centre and trial arm. While atony was the sole PPH cause in 53.2% (116/218) of the women in the responsive PPH group, it accounted for only 31.5% (45/143) of the causes in the refractory PPH group. Conversely, tears were the sole cause in 12.8% (28/218) and 28% (40/143) of the responsive PPH and refractory PPH groups, respectively. Placental problems were the sole cause in 11 and 5.6% in the responsive and refractory PPH groups, respectively.
conclusionWomen with refractory PPH showed a different pattern of maternal characteristics and PPH causes compared with those with first-line treatment responsive PPH. TWEETABLE ABSTRACT: Women with refractory postpartum haemorrhage are different from those with first-line treatment responsive PPH.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.