Primary PPH What Worsen Maternal Outcome?

Abstract

Objective: The aim of the study was to explore factors that worsen maternal outcome (maternal morbidity and mortality) in cases developed Primary Postpartum Hemorrhage (PPH). Methodology: Cross sectional observational study carried out during the period from July 2016 till June 2017, 387 cases were recruited in the study from those who developed 1ry PPH. All data concerning cases were recorded including personal, obstetric, medical history, details of medical services received, complications and maternal mortality. Analysis of data recorded was done to determine factors associated with worse maternal outcome (morbidity and mortality). Results: 387 cases developed 1ry PPH (either managed in or referred) to hospitals of Minia Governorate (two secondary hospitals and one tertiary hospital) during the period of the study. 87 cases were excluded due to incomplete records. 1y PPH was common in MG 53% , residents’ rural areas 63.7%, patients not booked for ANC 59.7% and anemic patients 67.9%. Bivariate correlation of factors that worsen maternal outcome showed positive correlation between maternal complications and maternal age, parity, residence (rural areas), distance between residence and hospital (far), positive history of medical problems (anemia), blood transfusion and number of blood units. Maternal complications developed in 13.3%, coagulopathy was the most common 37.5%. 9 cases developed maternal mortality (3%) most common cause of death was irreversible shock 44.4%. Conclusion: Factors that worsen the maternal outcome in patients who developed primary PPH are residence in rural areas, decrease awareness of ANC importance, high parity, advanced maternal age, prevalence of anemia and decrease number of well qualified hospitals.