Frequency of postpartum haemorrhage in maternal mortality in a tertiary care hospital

ABSTRACT

To determine the frequency of postpartum haemorrhage as a cause in maternal mortality during a period of seven years in a tertiary care hospital. This descriptive study was conducted in Gynae A unit of Department of Obstetrics and Gynecology, Lady Reading Hospital Peshawar. Data was collected from maternal mortality records retrospectively from 1[st] January 2003 to 31[st] December 2009. All patients who died in the hospital with a diagnosis of postpartum haemorrhage as the primary cause of death were included in the study. A total of 302 maternal deaths were recorded during the study duration. Out of these 302, 74 were due to Post-partum Haemorrhage which constituted 24.5% of maternal deaths. The mean age of the sample was 29.69 +/- 7.10. Uterine atony was the cause of death in 45.9% [n=34], rupture uterus in 32% [n=24], genital tract tears in 14.86% [n=ll] and retained placenta in 6.75% [n=5] of the cases of Postpartum Haemorrhage. Subtotal abdominal hysterectomy was performed in 51.35% [n=38]; repair of tears and removal of placenta in 6. 75% [n=5] each; Subtotal abdominal hysterectomy with internal iliac If gat ion was performed in 5.4% [n=4] cases while only internal iliac ligation and B Lynch suture was applied in 1.35% [n=l] each. The remaining 20 cases expired before they could be prepared for it. Postpartum Haemorrhage was found to be leading cause of maternal mortality making up to one quarter of total deaths in 7 years. Uterine atony and ruptured uterus were the major causes of Postpartum Haemorrahge. Subtotal abdominal hysterectomy was the major procedure performed