Evaluation of etiology & continuum of management protocol of postpartum haemorrhage  A prospective study

Abhilasha Singh; Smiti Nanda; Vani Malhotra

Volume : VI, Issue : VI, June - 2017

Evaluation of etiology & continuum of management protocol of postpartum haemorrhage A prospective study

Abhilasha Singh, Smiti Nanda, Vani Malhotra

Abstract :

Postpartum hemorrhage (PPH) is one of the leading causes of death in women. Women who deliver after 20 weeks of gestation are specially at risk for PPH and its sequelae. This study was undertaken to evaluate the causes and risk factors associated with PPH, various techniques/modalities used to control PPH and to assess the impact of PPH on the maternal morbidity and mortality. This prospective study was carried out over a period of six months from September 2014 to Feuary 2015 in the Dept. of Obstetrics and Gynaecology, Pt. B.D. Sharma PGIMS, Rohtak. All the women who had PPH after vaginal delivery or caesarean section along with the cases of PPH referred from outside were included. Detailed history was taken. General and local examinations were done to assess the cause of PPH. The patients were followed up in the hospital for all morbidity complications. Incidence of PPH in present study was 2.73%. Maximum number of cases (n=65, 48.14%) were among age group of 20–24 years with parity P1 (n=62, 45.92%), P2 (n=45, 33.33%), P3 (n=19, 14.07%) and P4 (n=7, 5.18%). Anaemia was found to be most common (n=44, 32.5%) risk factor followed by placenta praevia (n=14, 10.3%) and previous LSCS (n=10, 7.40%). Pre–eclampsia was risk factor among 4 cases. Primary PPH is an extremely challenging obstetric emergency associated with significant morbidity and still one of leading causes of maternal mortality. Early recognition and treatment are essential to ensure the best outcome from this life threatening condition. Though hysterectomy is the definitive treatment in women with severe PPH but in patients who desire future fertility, medical management, mechanical methods like uterine compression, uterine packing, uterine tamponade and surgical procedures like uterine artery ligation and uterine compression sutures are effective methods.