Postpartum hemorrhage: an experience at tertiary care hospital

ABSTRACT

To determine the frequency, causes and various treatment methods used in for postpartum hemorrhage [PPH] our setup. Descriptive study. This study was conducted in the Department of Obstetrics and Gynecology Unit 1, Liaquat University of Medical and Health Sciences Hyderabad, from June 2007 to April 2008. All women admitted with or developed PPH in hospital after delivery or cesarean section were included. Patients with history of bleeding disorders and those on heparin/warfarin were excluded. Results were analyzed through computer software program SPSS version 11 and percentages were used to describe the data. Total number of obstetric admissions during the study period was 1231. Out of these 118 [9.5%] patients developed PPH. Out of these 118 patients, 98[83%] patients had primary PPH while 20[16.9%] patients had secondary PPH. Seventy five [63.5%] patients were unbooked while 43[36.4%] were booked. Regarding causes of PPH, most common cause was uterine atony in 76[64.4%] cases, followed by perineal and vaginal tears in 41[34.7%] patients and prolonged labor in 29[24.5%]. Uterine massage was done in 76[64.4%] patients, B-Lynch sutures were applied in 6[5%] cases and hysterectomy done in 4[3.3%] patients. Majority of patients developed primary PPH and the commonest cause was uterine atony. PPH was commonly seen in unbooked patients, induced/ augmented labor and grand multiparous women