FREQUENCY OF CAUSES OF PRIMARY POSTPARTUM HAEMORRHAGE IN A TERTIARY CARE HOSPITAL

Abstract

Abstract Objective: To study the frequency of causes of pri-mary postpartum hemorrhage (PPH) in women man-aged in a tertiary care Hospital. material and Methods: The study was conducted in the department of Obstetrics and Gynecology, Unit - l, Lady Willingdon Hospital/ King Edward Medical Uni-versity, Lahore from July 2013 to December 2013. All the women having postpartum haemorrhage after vagi-nal delivery in the labour room or referred with pri-mary postpartum haemorrhage were included in the study and were evaluated to see the frequency of post-partum haemorrhage as well as the causes of PPH in women being treated in a tertiary care unit. Results: During the study period 1344 women deli-vered in unit I and 250 patients developed postpartum haemorrhage giving frequency of primary postpartum haemorrhage 18.60%. Majority of the women 29.6% (n = 74) were between 26 - 30 years of age, mean and Munir S.I. 1 Assistant Professor KEMU / Lady Willingdon Hospital, Lahore Sadiq A. 2 Postgraduate Trainee King Edward Medical University, Lahore Ishtiaq S. 3 Assistant Professor Ziauddin Medical University, Karachi SD was 28.43 ± 4.76 years. The gestation of 55.2% (n = 138) patients was between 37 - 40 weeks. The frequency of postpartum haemorrhage in booked women during antenatal period was recorded as 25.2% (n = 63) while 74.8% (n = 187) were not booked in any health facility. Among patients who developed PPH, uterine atony was the most common cause 57.6% (n = 144), followed by genital tract tears which was 29.2% (n = 73). The rest of the causes of PPH were retained pla-centa in 10% (n = 25), uterine rupture in 3.6% (n = 9) and uterine inversion in 1.6% (n = 4). Conclusions: Postpartum haemorrhage is still a lead-ing but preventable cause of maternal morbidity and mortality in our country due to under utilization of health facilities, the major cause is uterine atony follo-wed by perineal tears. Key Words: Primary postpartum hemorrhage, ante-natal care in tertiary care hospital, uterine atony, peri-neal tears.