Pattern of Peripartum Haemorrhage in a Tertiary Care Centre
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 2
Abstract
Introduction: Obstetric haemorrhage still remains the leading cause of maternal mortality worldwide. The Confidential review of maternal deaths in Kerala from 2004-2009 has shown that obstetric haemorrhage tops the list and steps to improve obstetric standards have been introduced in Kerala since 2014.It has also emerged as the major cause of severe maternal morbidity. Materials and Methods: This is a retrospective descriptive study conducted in a tertiary care centre in south Kerala to analyse the pattern of peripartum haemorrhage during the period from January to December 2016. Blood loss more than 500ml within a period of 24 hrs prior and after parturition irrespective of the mode of delivery was considered as peripartum haemorrhage. The cases were grouped into 4 according to the magnitude of transfusion. Results: Of the 8520 births in the institution 140 cases had peripartum haemorrhage (1.64%). Cases with haemorrhage referred after parturition was 24. Cases which did not receive transfusion belonged to group 1(29.88%). Majority (48.78%) belonged to group 2 with transfusion of ≤ 2 PRC. Massive transfusion was received by 7.92%. The proportion of atonic postpartum haemorrhage was 70/164 (42.68%). Abruptio placenta accounted for 25% and placenta previa for 20.12 % of peripartum haemorrhage. Morbidly adherent placenta previa was the major contributor of massive haemorrhage and peripartum hysterectomy. A single maternal mortality due to haemorrhage was due to severe preeclampsia, HELLP, DIC Conclusion: Atonic PPH remains the prime causeof peripartum haemorrhage. Morbidly adherent placenta previa in previous caesarean had become a major contributor of massive haemorrhage, massive transfusion, obstetric hysterectomy and maternal near miss.
Authors and Affiliations
Dr Manjula M
Keywords
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