Risk factors for primary postpartum hemorrhage

ABSTRACT

To describe the associated risk factor for primary Postpartum Hemorrhage [PPH] and its severity with increasing parity and duration of labour. It was a descriptive study. Place and duration of study The Department of Obstetrics and Gynecology [Unit II] of Bahawal Victoria Hospital, Bahawalpur from January 2004 to December 2004. Patient and method: Fifty patients with primary postpartum hemorrhage were included in this study. Data was collected from the patients through a structured proforma. The variable studied were parity, duration of labour and risk factors for primary PPH. The results were statistically analyzed, chi-square test was applied to find out the significance of parity and duration of labour and their relationship with severity of PPH. Simple percentages were used to find associated risk factor for primary PPH. The frequency of primary PPH in primary para was 24% [12 patients] and in multi para was 76%[38 patients]. Severity of PPH increased with increasing parity [P<.05]. After merging the variable of parity severity of PPH increased in patients with prolonged labour in normally delivered patients [P<.05]. As for as risk factors are concerned 60% had uterine atony while 16% got cervical tear and the same number had retained placenta, 8% had preneal tear, Uterine inversion was seen in 6%, 4% presented with polyhydrominos, same with placenta previa type-1. 4% had vaginal laceration, 2% had DIC and 2% had abruptio placenta. The result of the study revealed a number of associated risk factors for primary PPH and proved the relationship of its severity with increasing parity and duration of labour. Duration of labour had a significant relationship with PPH even in Primipara