Prospective study of various methods used in the management of post partum haemorrhage

Abstract

Introduction: Mismanagement of postpartum haemorrhage (PPH) is the major reason for the maternal morbidity and mortality throughout the world, highest incidence is found in developing countries. Aims and objective: To study the various methods used to control PPH in all the deliveries that took place at the study place. Materials and Methods: Prospective study was performed on 402 PPH patients in the Department of Obstetrics and Gynecology, Kamla Raja Hospital, GR Medical College, Gwalior from Sept., 2014 to Aug., 2015. All the patients were divided in to atonic PPH and traumatic PPH. Patient’s detailed history including obstetric history, menstrual history and history of drug allergy were recorded in pre-approved excel format. Patients were managed either by catheterization and uterine massage, using uterotonic drugs, uterine packing and surgical intervention such as internal iliac ligation and/or hysterectomay. Results: Out of total 7977 deliveries, 62.09% were vaginal and 37.91% were caesarean section. Out of that 402 (5.03%) developed PPH. Mean age of study population was 23.3±1.37 years. Out of 402 PPH patients, 75% were having atonic PPH whereas 19.65% were having traumatic PPH. Most of the patients with atonic PPH were managed by uterotonic drugs (69%) followed by cathererization with uterine massage (25%). Most of the patients with traumatic PPH were found to be due to hematoma or tear and were managed by haematoma drainage (58%) followed by perineal with vaginal repair (33%). Conclusion: Uterotonic drugs were the most commonly used for the management of atonic PPH whereas haematoma drainage was mostly used in patients with traumatic PPH. Keywords: Uterotonic drugs, Post partum haemorrhage, Atonic PPH, Traumatic PPH.