Mechanisms, Equipment, HazardsIncreasing Incidence of Postpartum Hemorrhage: The Dutch Piece of the PuzzleVan Stralen, G.; Von Schmidt Auf Altenstadt, J.F.; Bloemenkamp, K.W.; Van Roosmalen, J.; Hukkelhoven, C.W. Author Information Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands Obstetric Anesthesia Digest: December 2016 - Volume 36 - Issue 4 - p 205 doi: 10.1097/01.aoa.0000504734.82411.74 Buy Metrics Abstract (Acta Obstet Gynecol Scand 2016. [Epub ahead of print]) The global maternal mortality ratio has declined significantly since the 1990s and, currently, is very low in countries like the Netherlands (7/100,000 live births). One of the leading causes of maternal mortality is postpartum hemorrhage (PPH), defined in this study as >1000 mL blood loss within 24 hours of childbirth, regardless of delivery mode. PPH has recently been linked to several potential risk factors, ranging from ethnicity and obesity to cesarean section (planned and emergency) and augmented labor. However, studies are not consistent. In order to elucidate PPH trends and any associations that PPH may have with such risk factors, the authors of the present study described the incidence of PPH in the Netherlands over a period of 13 years (2000 to 2013). Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.