RESUMEN
Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. We focus on two innovations by Indian gynecologists, the Panicker’s vacuum suction cannula and the SR suction cannula. These effective devices are economical and easy-to-use, and help prevent and manage PPH. They can also be used to reduce bleeding in non-PPH indications. These Indian innovations are a matter of pride, and need to be studied extensively in diverse settings. This will help ensure that their benefits can be shared across the world.
RESUMEN
Background: PPH is responsible for 25% of all maternal deaths. In India, PPH incidence in India is 2%-4% following vaginal delivery and 6% following cesarean section. PPH as the important cause of 19.9% of maternal mortality in India. The objectives of the study were to study the incidence, risk factors, cause, morbidity and mortality pattern and management of PPH.Methods: This is a cross-sectional study conducted among 102 pregnant women selected by convenient sampling and admitted in labour room during the study period who will be deliver by vaginally or by caesarean section. The patient having PPH were divided into two groups: Group I: Patients having primary atonic PPH, Group II: Patients having traumatic PPH.Results: Mean age of participants was 33.6 and 32.9 years, 59.3 and 51.2 have ‘0’ parity, mean BMI 22.8 and 23.9 kg/m2, 34.6% and 17.1 babies were delivered by LSCS, 11.7% and 12.2% have history of PPH in the group of atonic and traumatic respectively. In the group of atonic PPH cases, 77.2%, 15.4%, 4.3% and 3.1% cases managed by the method of ‘Uterotonics +<2 blood transfusions’, ‘Uterotonics + >2blood transfusions’, ‘Perineal Tear Repair’ and ‘Surgical Intervention’ respectively. All the traumatic PPH cases (100.0%) were managed by ‘surgical intervention’.Conclusions: A multi-disciplinary approach include medical, mechanical, surgical and radiological is required in severe haemorrhage. Availability of blood and blood products is very crucial. Prediction and assessment of blood loss and timely identification of uterine atony are remaining the cornerstone for prompt and effective management of PPH.
RESUMEN
To assess, evaluate and compare the safety and efficacy of i/m PGF2 125 mcg and i/v methylergometrine 0.2 mg during active management of third stage of labor in high risk pregnant women who are prone to develop atonic postpartum hemorrhage. The study was conducted on two hundred women prone to develop PPH with vertex presentation and spontaneous onset of labor at term. Slected cases were divided into two groups: Group I – Comprised of 100 women who were given 125 microgram of intramuscular 15 methyl PGF2 (Carboprost) at the time of delivery of anterior shoulder prophylactically. Group II – Comprised of 100 women who were given 0.2 milligrams of intravenous methylergometrine, at the time of delivery of anterior shoulder prophylactic ally. Tools of statistical analysis used were paired ‘t’ test , ‘Z’ test and mean ± SD. The mean duration of the third stage of labor after giving uterotonic drug was significantly shorter in Group I (3.50 ± 1.10 mins) as compared to Group II (5.15 ± 1.30 min) (p<0.001).The mean blood loss was significantly less in Group I (85 ± 30 ml) versus Group II (185 ± 40 ml) (p<0.0001).There was no statistical difference in mean haemoglobin concentration observed before and 48 hrs after delivery. The only significant side effect was diarrhoea in Group I. Prophylactic intramuscular PGF2 125 mcg is a better alternative to prophylactic intravenous methylergometrine 0.2 mg in high risk pregnant women who are prone to develop atonic PPH.