Association Between Intravenous Fluids During Labor and Primary Postpartum Hemorrhage: A Retrospective Cohort Study

( Acta Obstet Gynecol Scand . 2024;103(8):1541-1549. doi: 10.1111/aogs.14896) A major proportion of global maternal deaths are due to primary postpartum hemorrhage (PPH), which is defined as maternal blood loss ≥500 mL within the first 24 hours of delivery. Primary PPH typically results in higher levels of intervention both immediately after delivery and at the beginning of the postpartum period. One major cause of PPH is uterine atony, and this has been rising in prevalence in the last 2 decades without an explanation from risk factors or reporting. One plausible explanation for this rise is the use of intravenous (IV) fluids during labor impairing contractility of the uterus due to swelling or metabolic acidosis. This study was designed to evaluate whether there is a relationship between the administration of IV fluids during labor and PPH, assessing adverse outcomes and comparing high-volume and low-volume IV fluids.