A Retrospective Study of Risk Factors and Outcome Analysis of Post Partum Haemorrhage in A Tertiary Care Hospital
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Introduction: Postpartum hemorrhage is important cause of maternal mortality in developing as well as developed countries. It is defined as blood loss of more than 500ml in normal vaginal delivery and more than 1000ml in a case of caesarean section or amount of blood loss that can affect hemodynamic stability of patient. It is a significant cause of maternal morbidity and mortality. Materials and Methods: This was a cross sectional observational study conducted in a Tertiary care hospital, MGM Medical College and Hospital, Jamshedpur conducted from November 2016 to June 2018 having high no of referrals from city as well as periphery. On admission to the hospital their detailed history such as name, age, parity, socio economic status, address, whether booked or unbooked, whether handled at home by untrained dais / relatives, at PHC’s by health workers, medical officers, or at private nursing home were noted. A complete obstetric history included duration of pregnancy, duration of onset of pain, history of vaginal leak, history of bleeding, etc. In case of referred case, time, date, place of referral, method of interventions like use of IV fluid, use of oxytocin, epidosin, per vaginal examination, ARM, any inducing agent instillation, episiotomy given, any instrumental use, blood transfusion, whether manual removal of placenta was tried were noted. A detailed past obstetric history, past menstrual history, past history, family and personal history were noted. Results: The cross tabulations were used to study the demographic, obstetrical and medical factors in women with severe obstetrical haemorrhage. Total number of patients admitted in labour room was 8016 and 8012 patients delivered during this period. Results showed that severe obstetrical haemorrhage (more than 1500 ml) was in 110 patients (prevalence of 1.37%). Conclusion: The prevalence of severe obstetric haemorrhage was 1.37 %.The frequency and impact of severe hemorrhage can be effectively reduced by reducing avoidable risk factors, especially those related to obstetric interventions as increased CS rate and induction of labor. Other risk factors not amenable to change such asage, ethnic origin, and preexisting medical diseases or bleeding disorders can be minimized by extra vigilance and planned conjoined management. The result of the study indicate that severe obstetric haemorrhage can be used as an indicator to the assess the level of obstetric care. By identifying the risk factors of severe obstetrical haemorrhage, preventive measures can be taken to avoid feto maternal morbidity & mortality.
Authors and Affiliations
Dr Nootan Dayal, Dr Manjula Srivastava
Keywords
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- EP ID EP574483
- DOI 10.9790/0853-1804120610.
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