Frequency, Management and Outcome of Postpartum Hemorrhage at a tertiary care Hospital.

Abstract

Introduction: According to WHO, world estimates of 2017, 295 000 maternal deaths were reported all over the world and maternal mortality rate ranged from UI 99 to 243 per 100 000 live births. There has been 35% reduction since year 2000. Similarly, there has been 51% reduction in maternal mortality rate in Pakistan. 94% of all maternal deaths occur in low and lower middle-income countries. The major complications that account for nearly 75% of all maternal deaths are: severe bleeding mostly Post-Partum Hemorrhage (PPH), Postpartum sepsis, pre-eclampsia and eclampsia and other.

Objective: To find out the frequency of patients presenting with PPH among all patients delivered during the study period, their management and subsequent morbidity and mortality.

Methodology: This retrospective study was conducted between January 2018 to December 2019 at the department of Obstetrics and Gynecology PUMHS Hospital Nawabshah, Benazirabad.  The demography, parity, gestational age, mode of delivery and type of PPH developed as well as treatment for PPH and subsequent morbidity and mortality were all documented. Data analyzed using SPSS version 20.

Results: During study period frequency of PPH was 32.73 per 1000 deliveries, prevalence of primary PPH was 90.51%. Among the causes of PPH, Uterine atony was the leading cause 42/137 (30.65%). 56 (40.87%) patients were managed in the ICU for ventilatory &, inotropic support and septic shock, management. Mortality was 7(5%).

Conclusion:  Majority of patients are of primary PPH and uterine atony remains the most common cause of PPH which requires prompt and timely management as per guidelines.