Primary Postpartum Hemorrhage and Maternal Health-Effects and Outcome

Abstract

Objective: To assess outcome of different management strategies in women presenting with primary postpartum hemorrhage (PPH). Study Design: Observational, prospective. Settings: Department of Obstetrics & Gynecology Unit-III, Liaquat University of Medical and Health Sciences, Jamshoro Pakistan. Duration: From May 2016 to November 2017. Methodology: Total 50 delivered women fulfilling the inclusion criteria were included in study. All relevant variable like a detailed demographic characteristics, details about labour, symptomatology, general conditions of patient, amount of blood loss, clinical examination, finding such as condition of the uterus, genital tract trauma, retained placenta, uterine inversion. Investigation like complete blood picture blood group, blood sugar, coagulation profile, serum electrolytes, virology status, liver function test, renal function test, ultrasound examination, maternal effects and outcome were recorded on proforma and analyzed by using SPSS. Results: Among 50 women (with primary PPH) included in this study, all were managed medically, in 24 patients medical treatment was unsuccessful so surgical treatment offered. Most common cause identified was uterine atony, however anemia 50(100%).  Hypovolemic shock 5(10%), puerperal sepsis 8(16%), complication of anesthesia 4(8%), blood reactions 6 (12%) were the morbidities observed in present study, 2 patients (4%) died inspite of all measures. Conclusion: It was concluded that best results were obtained with use of AMTSL, combination of more than on medical option and surgical management were equally effective in treating the PPH.