Massive Obstetric Hemorrhage: Etiology, patient characteristics, management and its outcome in Tertiary Care Centre.

Dr ASHISH N ZARARIYA; Dr HARSHIKA BHAGAT

Volume : IX, Issue : VI, June - 2020

Massive Obstetric Hemorrhage: Etiology, patient characteristics, management and its outcome in Tertiary Care Centre.

Dr Ashish N Zarariya, Dr Harshika Bhagat

Abstract :

Background: Obstetric hemorrhage is one of the most common causes of maternal deaths causing 25% with estimated 1,27,000 deaths annually in developed and developing countries (WHO). Massive Transfusion Protocol (MTP) is the recommended therapeutic transfusion strategy for the clinical management of Massive Obstetric Hemorrhage. Methods : An observational study, on 75 women, during 18 months duration with MOH causing hemoglobin deficit of > 4 g/dl was done. Amount of Blood loss estimated visually and co-related with laboratory parameter changes. Patient characteristics and etiologies were studied. Maternal outcome studied in terms of interventions and complications. Results: MOH was more common in multigravida (72%) almost equal occurence in antepartum (44%) and postpartum (45%) period. Most common causes were Auption(24%), Atonic PPH(28%).Majority had estimated blood loss of 1500-2000ml (78.67%). Median number of PRBC transfused is 5 and FFP is 4. Ratio established is PRBC:FFP 1.17:1. Most common complication was DIC (35%), Acute Kidney injury (21%) and Bladder injury(14%). Mortality observed in 12% study population.