PREVALENCE AND OUTCOME OF POSTPARTUM HAEMORRHAGE IN TERTIARY CARE HOSPITAL
Main Article Content
Keywords
Prevalence, Outcome, Postpartum Haemorrhage
Abstract
Background: The most terrifying event a woman may anticipate is death during childbirth, which continues to be the predominant cause of maternal mortality. Postpartum Haemorrhage is a common problem in less developed countries like Pakistan.
Objective: To assess the prevalence and outcome of Postpartum Haemorrhage in tertiary care hospital
Methodology: The current cross-sectional study was carried out at Pir Sayed Abdul Qadir Shah jilani institute of medical sciences Gambat. The duration of our study was six months from December 2019 to May 2020. In order to determine the frequency of PPH, all the deliveries were recorded during the study duration. Following written informed permission, demographic information including age, gestational age, and parity was entered into a pre-made proforma. For the data analysis we use SPSS version 24.
Results: In the current study, a total of 250 women were included. The mean age (SD) in the current study was 28 (4.32) years. The overall frequency of postpartum hemorrhage was 10 (4%). Amongst the 10 patients with postpartum hemorrhage, 8 (80%) patients were had primary postpartum hemorrhage while 2 (20%) patients had secondary postpartum hemorrhage. Based on causes of postpartum hemorrhage, uterine atony was observed in 5(50%) patients, perineal and vaginal tears in 3 (30%) and prolonged labor was observed in 2 (10%) patients. Based on outcomes, out of 10 postpartum hemorrhage patients, 1 (10%) women were observed with DIC and 1 (10%) patient had pulmonary edema. The overall mortality rate was 1 (10%).
Conclusion: Our study concludes that the frequency of postpartum haemorrhage is high with a prevalence of 4%. Primary PPH was common as compared to secondary PPH. The major cause of PPH was Uterine atony
References
2. Knight M, Callaghan WM, Berg C, Alexander S, Bouvier-Colle M-H, Ford JB, et al. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth. 2009;9(1):1-10.
3. Sheikh L, Najmi N, Khalid U, Saleem T. Evaluation of compliance and outcomes of a management protocol for massive postpartum hemorrhage at a tertiary care hospital in Pakistan. BMC Pregnancy Childbirth. 2011;11:1-7.
4. Organization WH. WHO recommendations for the prevention and treatment of postpartum haemorrhage: World Health Organization; 2012.
5. Organization WH. Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA, and the World Bank. 2007.
6. Mazhar SB, Batool M, Batool A. Post partum hemorrhage and its predisposing factors In WHO Multi-Country Survey on Maternal and Newborn Health, Pakistan. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 2018;8(2):104-9.
7. Raheela A, Tasneem A, Shakila A, Nagina A, Fazila A. Effectiveness of per rectal misoprostol versus intramuscular oxytocin for prevention of primary postpartum haemorrhage. 2017.
8. Abou-Zahr CL, Royston E, Organization WH. Maternal mortality: a global factbook: World Health Organization; 1991.
9. Cook L, Roberts I. Post–partum haemorrhage and the WOMAN trial. Oxford University Press; 2010. p. 949-50.
10. Yousuf N, Farooq F, Yousuf K, Ali R, Yasmeen F, Ramzan S. Frequency, Management and Outcome of Postpartum Hemorrhage at a tertiary care Hospital. JMMC. 2020;11(1):13-6.
11. Ramejo BB, Ramejo MA, Soomro S, Tunio MA, Ramejo MA. Frequency and Clinical Outcomes of Women with Postpartum Hemorrhage at a Tertiary Care Hospital. Pakistan Journal of Medical & Health Sciences. 2019;16(11):778-.
12. Ramani S, Vijaya B. Prevalence and outcome of primary postpartum haemorrhage in a tertiary care hospital: a hospital record based study.
13. Waheed G, Toheed R, Mansha M, Bin Ayub T. Comparison of causes of postpartum haemorrhage following vaginal deliveries and caesarean sections in a tertiary care hospital of Pakistan. Pakistan J Med Health Sci. 2013;7:5885-9.
14. Naz H, Sarwar I, Fawad A, Nisa AU. Maternal morbidity and mortality due to primary PPH-- experience at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad. 2008;20(2):59-65.
15. Gani GN, Ali AT. Prevalence and factors associated with maternal postpartum haemorrhage in Khyber Agency, Pakistan. Journal of Ayub Medical College Abbottabad. 2013;25(1-2):81-5.
16. Gul F, Jabeen M. Frequency, causes and outcome of post partum haemorrhage at liaqat memorial hospital kohat, pakistan. Khyber Medical University Journal. 2018;10(2):90-4.
17. Zabeen B, Nahar J, Ahmed B, Tayyeb S, Islam N, Azad K. Vitamin D status in children and adolescents with type 1 diabetes in a specialized diabetes care centre in Bangladesh. Endocrinology, diabetes & metabolism. 2019;5(1):e00312.
18. McLintock C. Prevention and treatment of postpartum hemorrhage: focus on hematological aspects of management. Hematology 2014, the American Society of Hematology Education Program Book. 2019;2019(1):542-6.
19. Hu J, Yu Z-P, Wang P, Shi C-Y, Yang H-X. Clinical analysis of postpartum hemorrhage requiring massive transfusions at a tertiary center. Chin Med J. 2017;130(05):581-5.
20. Farzi F, Mirmansouri A, Roshan ZA, Nabi BN, Biazar G, Yazdipaz S. Evaluation of admission indications, clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit of a teaching hospital center: a five-year retrospective review. Anesthesiology and pain medicine. 2017;7(3).
21. Keizer JL, Zwart JJ, Meerman RH, Harinck BI, Feuth HD, van Roosmalen J. Obstetric intensive care admissions: a 12-year review in a tertiary care centre. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2006;128(1-2):152-6.
22. Mavrides E, Allard S, Chandraharan E, Collins P, Green L, Hunt B, et al. Prevention and management of postpartum haemorrhage. BJOG. 2016;124(5):e106-49.
23. Gulumser C, Engin-Ustun Y, Keskin L, Celen S, Sanisoglu S, Karaahmetoglu S, et al. Maternal mortality due to hemorrhage: population-based study in Turkey. The Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(23):3998-4004.
24. Blosser C, Smith A, Poole AT. Quantification of blood loss improves detection of postpartum hemorrhage and accuracy of postpartum hemorrhage rates: a retrospective cohort study. Cureus. 2018;13(2).
25. Davey MA, Flood M, Pollock W, Cullinane F, McDonald S. Risk factors for severe postpartum haemorrhage: A population‐based retrospective cohort study. Aust N Z J Obstet Gynaecol. 2018;60(4):522-32.
26. Sharma B, Sikka P, Jain V, Jain K, Bagga R, Suri V. Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomes. J Anaesthesiol Clin Pharmacol. 2017;33(3):324.