A Retrospective Study of Maternal and Perinatal Outcome in Patients of Postpartum Haemorrhage in A Tertiary Care Hospital
A Retrospective Study of Maternal and Perinatal Outcome in Patients of Postpartum Haemorrhage in A Tertiary Care Hospital
A Retrospective Study of Maternal and Perinatal Outcome in Patients of Postpartum Haemorrhage in A Tertiary Care Hospital
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20161686
Research Article
INTRODUCTION
Postpartum hemorrhage is important cause of maternal
mortality in developing as well as developed countries. It
is defined as blood loss of more than 500ml in normal
vaginal delivery and more than 1000ml in a case of
caesarean section or amount of blood loss that can affect
hemodynamic stability of patient.1,2 It is a significant
cause of maternal morbidity and mortality. Primary PPH
is defined as blood loss within 24 hours of delivery and
Secondary PPH is blood loss after 24 hours of vaginal
delivery.2-4 Prevalence of postpartum hemorrhage is 6%
worldwide and Africa being the one with the highest
prevalence rate of 10.1%.5. Maternal Hemorrhage is the
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METHODS
It was a record based retrospective study. The Central
Registration Number of patients admitted with the
diagnosis of post-partum hemorrhage from September
2014 to February 2015 was noted from the records
available in the labor Room. These files were retrieved
from the Medical Record Section. Files of seventy six
patients admitted with diagnosis of postpartum
hemorrhage during the study period were retrieved and
extensively analysed. The patients demographic details,
various risk factors, etiology of postpartum hemorrhage
and mode of delivery, type of management viz. medical
management, surgical management or combined
(Medical and Surgical) management, maternal
complications etc. were studied in detail. The maternal
and perinatal outcome was also analysed in detail from
the patients case files.
Data analysis
The data was entered into the excel sheet and the data
base was created. The data was analysed in detail and
various tables were prepared and analysis was done.
Ethical justification
RESULTS
Table 1: Sociodemographic profile and other obstetrical details of patients suffering from post-partum
hemorrhage.
No.
1
2
3
1
2
1
2
1
2
Item
No. of patient
Age wise distribution
<20 Year
3 (4%)
21-30 year
67 (88%)
>31 year
6 (8%)
Religion wise distribution
Hindu
75 (99%)
Muslim
1(1%)
Area wise distribution
Rural
45 (59%)
Urban
31 (41%)
Place of delivery
Home
1 (1.3%)
Hospital Setting
75 (98.7%)
Sr. No.
1
2
3
4
1
2
1
2
1
2
Item
No. of Patient
Parity wise distribution
Para 1
38 (50%)
Para 2
23 (30.3%)
Para 3
7 (9.2%)
>Para 4
8 (10.52%)
Mode of delivery
Vaginal
45 (59%)
Caesarean
31 (41%)
Anti natal (ANC) visits
Booked
21 (27.63%)
Un Booked
55 (72.4%)
History of abortions
Yes
6 (8%)
No
70 (92%)
No. of
patients
42(55.26%)
4(5.26%)
4(5.26%)
2(2.63%)
2(2.63%)
1(1.31%)
5(6.57%)
19(25%)
6(7.89%)
Nature of complications
Maternal complications
1
Anaemia
3
DIC
4
Others
5
No Complications
Maternal outcome
1
Alive
2
Dead
Fetal outcome
No. of
patients
43 (56.6%)
4 (5.3%)
11 (14.5%)
19 (25%)
75 (98.7%)
1 (1.3%)
Live Birth
57 (75%)
2
3
NICU Admission
Still birth
12 (15.6%)
7 (9.2%)
DISCUSSION
As stated above the maternal hemorrhage is a leading
cause of maternal morbidity and mortality. Present study
aimed to find out the socio-demographic profile of
patients with postpartum hemorrhage, various risk factors
associated with it, its management and maternal and fetal
outcome in such cases. In our present study, it was found
that most of the patients with post-partum hemorrhage
had history of prolonged labor (26%) followed by history
of ante partum hemorrhage (20%) during their antenatal
period. This finding is in correlation with many studies,
where prolonged labour is cited as one of the most
common cause of post-partum hemorrhage, also there are
various studies in which ante partum hemorrhage is
described as an important risk factor of post-partum
2.
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CONCLUSION
10.
Postpartum hemorrhage is one of the biggest menace in
todays times especially in developing countries. In this
study it was observed that majority of the patients with
post partum hemorrhage were from rural background and
were in the age group of 21-30 years. The patients were
mostly primiparous. The commonest risk factor found in
this study was prolonged labor followed by antepartum
hemorrhage. The commonest underlying cause of PPH
was atonicity of the uterus. Out of total births, 75% were
alive and healthy babies followed by 16% babies who
were admitted in Neonatal Intensive Care Unit (NICU).
Encouragement of regular antenatal visits, timely referral
of high risk patients, training of health personals and
timely intervention can save many lives.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: Not required
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REFERENCES
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