Abstract: Background and Aim: Several risk factors for Postpartum hemorrhage (PPH) are known, such as multiple pregnancy, operative delivery and chorionamnionitis, however PPH may occur among patients with no known risk factors. In this research, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.
Material and Methods: Total numbers of vaginal deliveries in this period were 5235. Out of these, 1500 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. 200 out of 1500 patients were suspected to have PPH (blood loss of more than 500 ml) by visual estimation of blood loss by the attending consultant was noted to have PPH. Maternal comorbidities of preeclampsia, chronic hypertension, gestational hypertension, gestational diabetes, previous LSCS were noted. Using logistic regression, we applied a pragmatic strategy to identify independent risk factors for severe PPH.
Results: Out of 1500 patients, 200 patients had post-partum hemorrhage. The chi-squared test showed that there was no statistically significant difference between the two distributions of age groups. The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.
Conclusion: Presence of cervical tear and III-degree tear increased the chances of PPH. Further the study also showed that application of forceps in women with hypertension increases the risk of PPH though hypertension by itself did not seem to increase the risk in a statistically significant way. Any patient in labor might need assistance in the second stage.
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