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Updated: May 14, 2026

An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Risk factors for a prolonged third stage of labor and postpartum hemorrhage
Everett F Magann1, Monica A Lutgendorf, Sharon D Keiser
1Departments of Obstetrics & Gynecology and Biostatistics, University of Arkansas, Little Rock, Arkansas, USA.
Objectives:
To determine the effect of a third stage of labor ≥15 minutes on bleeding after delivery and other risk factors for a postpartum hemorrhage (PPH).
Methods:
This was a case-control study of women undergoing vaginal delivery with placental delivery ≥15 minutes matched by gestational age to the next delivery with placental delivery <15 minutes. Multiple risk factors were evaluated for association with delayed placenta and with PPH.
Results:
There were 226 pregnancies ≥15 minutes (cases) versus 226 whose placental time was <15 minutes (controls). The best-fit model identified placental delivery ≥15 minutes, history of retained placenta, nulliparity, and increased length of first stage of labor as significant factors for PPH.
Conclusions:
The best risk model for PPH includes placental delivery ≥15 minutes, history of retained placenta, nulliparity, and longer first stage of labor.
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