Background: Postpartum haemorrhage (PPH) remains a major cause of maternal morbidity and mortality, particularly in low-resource settings. Early identification of risk factors and timely intervention are essential to improving outcomes. This study investigates the aetiologies, risk factors, management patterns, and outcomes of PPH in a tertiary care centre.
Methods: A prospective observational study was conducted on 80 cases of PPH among 14, 442 deliveries between August 2022 and July 2024. Detailed clinical assessment, quantification of blood loss, laboratory evaluation, and management according to institutional protocols were undertaken. The findings were compared with established national and international literature.
Results: Primary PPH accounted for 92.5% of cases. Emergency or referred admissions constituted 80%, while 20% were registered patients. Most affected women were aged 25-30 years (50%). Uterine atony was the predominant cause (64.86%), followed by traumatic PPH (27.02%). Significant risk factors included previous caesarean section (25%), multigravidity (16.66%), placenta previa (12.5%), anaemia (14.5%), preeclampsia (8.3%), and placental abruption (8.3%). Medical management alone was effective in 32.5% of atonic PPH cases, primarily using oxytocin and misoprostol; uterine tamponade was used in selected cases. Surgical intervention was required in 67.5% of cases, including uterine artery ligation, internal iliac ligation, repair of genital tract injuries, manual removal of placenta, and one hysterectomy. Postoperative complications occurred in 18 patients. Maternal mortality was 2.5%, with deaths due to acute renal failure with DIC and dilated cardiomyopathy. Blood component therapy was required in most patients.
Conclusion: PPH is a preventable emergency requiring rapid recognition, coordinated multidisciplinary care, and access to effective medical and surgical interventions. Strengthening antenatal care and emergency referral systems can significantly reduce PPH-related maternal morbidity and mortality.
International Journal of Clinical Obstetrics and Gynaecology
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Research Journals