ABSTRACT
Hemorrhage associated with pregnancy remains one of the most serious complications affecting parturients and their yet-to-be-born children. Along with thromboembolic phenomena and hypertensive disorders, hemorrhage contributes to the ‘deadly triangle’, causing 64-68% of maternal deaths in the second and third trimesters of pregnancy and peripartum, half of the maternal deaths being postpartum. Whereas overall maternal obstetric morbidity is estimated at 12 cases per 1000 deliveries, hemorrhage accounts for slightly over half of recorded morbidity1. The adjusted odds ratio (OR) for severe hemorrhage in multifetal pregnancy was 2.29 (95% confidence interval (CI) 1.2-4.37)2. In Europe the maternal mortality rate in 1994 was estimated at 5.2/10 000 live singleton births versus 14.9/10000 live multiple births3. Stated another way, the maternal risk of death was triple in multiple gestations (OR 2.9, CI 1.4-6.1)3. It is logical to postulate that a substantial part of these deaths must be due to maternal hemorrhage in multifetal gestations.
