FREQUENCY, CAUSES AND OUTCOME OF POST PARTUM HAEMORRHAGE AT LIAQAT MEMORIAL HOSPITAL KOHAT, PAKISTAN
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Abstract
ABSTRACT
OBJECTIVE: To determine the frequency, causes and outcome of postpartum haemorrhage (PPH) at Liaqat Memorial Hospital (LMH) Khyber Medical University Institute of Medical Sciences (KIMS), Kohat, Pakistan.
METHODS: This descriptive study was conducted on diagnosed patients of PPH admitted in labour room of LMH, KIMS, Kohat, Pakistan. Data regarding mode of delivery, management and outcome of PPH was collected from January 2011 to December 2015. The blood loss measurement was subjective. The standard criterion for PPH definition and classification was used. The data was analysed via SPSS-21.
RESULTS: Out of 46266 deliveries during the study period, documented PPH cases were 1453 (3.14%). The most common cause of PPH was atonic uterus (n=566; 38.95%), followed by genital tract trauma (n=489; 33.7%). Primary PPH was seen in 1408 (96.9%) cases. Out of 1453 cases of PPH, 993 (68.34%) had C/section, 330 (22.71 %) were delivered vaginally and 130 (8.95%) had abdominal delivery for ruptured uterus. Conservative medical management was done in 535 (36.82%) patients; repair of various kinds of tears was done in 489 (33.65%) patients and subtotal abdominal hysterectomy in 198 (13.63%) cases. Nine (0.62%) patients had disseminated intravascular coagulation (DIC), 7 (0.48%) patients had ruptured bladder along with ruptured uterus, 5 (0.34%) patients had renal failure and 3 (0.21%) patients developed pulmonary edema. Thirty five (2.41 %) patients died due to PPH.
CONCLUSION: In all the observed patients of PPH, atonic uterus and genital tract trauma were the main causes while DIC and ruptured uterus were main complications of PPH.
KEY WORDS: Postpartum Haemorrhage (MeSH), Uterine Inertia (MeSH), Atonic uterus (Non-MeSH), Uterine Rupture (MeSH), Disseminated Intravascular Coagulation (MeSH), Maternal Mortality (MeSH), Subtotal abdominal hysterectomy (Non-MeSH)
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