Impact of assisted reproductive methods on the incidence of postpartum hemorrhage

The increased frequency of postpartum bleeding is observed all over the world. The increased use of assisted reproductive technologies prompts researchers to search for a possible relationship between these phenomena. The purpose — to analyze the frequency of postpartum bleeding depending on the use of in vitro fertilization methods. Material and methods. We performed a retrospective analysis of the frequency of postpartum bleeding in women after IVF (group 1A, n = 150) and after spontaneous pregnancy (group 1B, n = 240). Modern clinical and anamnestic, instrumental and laboratory methods were applied. Microsoft Excel, SPSS, and GraphPad Prizm software was used for statistical processing of the obtained results. Results. The incidence of postpartum bleeding in women whose pregnancy occurred as a result of IVF is significantly higher — 9.3 versus 4.6% in women with spontaneous pregnancy (F = 2.080, p < 0.001). The increased frequency of postpartum bleeding was proven in patients with a high risk of postpartum bleeding, emergency caesarean section, prenatal hemoglobin levels of 90 g/l or less, parity of 4 or more births, and the actual pregnancy resulting from IVF/ICSI with the transfer of thawed embryos (AUC 0.918, p < 0.001, 95% CI 0.867–0.969). Conclusion. It is necessary to take into account the impact of assisted reproductive technologies on the increased frequency of postpartum bleeding in the early postpartum period. This proves the need for careful postpartum monitoring of such patients, carrying out delivery of these pregnant women in level 3 maternity hospitals where an interdisciplinary team can be involved in order to preserve women’s reproductive health.