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Volume 12 Issue 4 ( October-December ) 2023

Original Articles

A Comprehensive Analysis of Risk Factors and Management Strategies for Postpartum Hemorrhage: A Prospective Observational Study
Dr. Sunita Attri, Dr. Tania Verma

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide. This prospective observational study aims to investigate and identify the risk factors associated with postpartum hemorrhage, contributing to a deeper understanding of its etiology and the development of effective preventive strategies. Methods: A one year observational study was conducted at Department of Obstetrics and Gynaecology, SMGS Hospital, GMC Jammu with effect from December 2019 to November 2020. The study enrolled 60 pregnant women aged over 18, who delivered at the hospital. Inclusion criteria comprised specific blood loss thresholds, bleeding causing hemodynamic instability, or >10% decline in postpartum hemoglobin, necessitating blood transfusion. Exclusion criteria applied to women unable to provide consent or unwilling to participate. Results:The study cohort, primarily aged between 20-24, constituted 51.7%, with decreasing representation in subsequent age groups. Primiparous individuals dominate at 61.7%, while gestational age distribution was relatively balanced. Normal vaginal deliveries (NVD) prevailed at 68.3%, contrasting with 31.7% cesarean section (LSCS). Anemia was prominent in 31.7%, and 23.3% had a history of Previous Lower Segment Cesarean Section (LSCS). Hypertensive disorder of pregnancy was noted in 18.3%, Premature Rupture of Membranes in 13.3%, Abruptio Placentae in 10.0%, and prolonged labor in 3.3%. Uterotonics were universally administered (100%), with surgical interventions and blood transfusions at 81.7% and 80.0%, respectively. Mortality incidence is notably low at 1.7%, with 98.3% demonstrating resilience. Conclusion: The study revealed significant risk factors for postpartum hemorrhage (PPH), including younger maternal age, primiparity, preterm birth, lower segment cesarean section, anemia, previous cesarean section, pregnancy-induced hypertension/pre-eclampsia, placental abruption, and premature rupture of membranes. Postpartum management, incorporating uterotonics and surgical interventions, proved vital in mitigating adverse outcomes.

 
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