Postpartum haemorrhage: A cause of severe acute maternal morbidity and mortality
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 3
Abstract
Objectives: To know the incidence of Severe Acute Maternal Morbidity (SAMM) and Mortality because of Post-Partum Hemorrhage (PPH). To categorize PPH cases to enable prediction of severity of PPH possible in order to prevent mortality. Methods: It is a retrospective analysis of cases of PPH managed at this centre over a period of two years. The cases were analysed for the interventions done to manage PPH. Cases of PPH were categorized into uncomplicated and complicated as per predefined criteria. Cases both delivered in this institution and referred from outside were included. Cases referred out were not included. Results: During the study period of two years 9060 women delivered. During the same period 86 cases of PPH were managed. 55 cases of PPH were from this hospital delivered women giving a rate of 6/1000 deliveries. 31cases of PPH were managed as referrals to this hospital. Out of 86, 27 suffered massive blood loss and required multiple interventions, we categorized them as ‘complicated PPH’. 8 deaths occurred due to PPH during this study period and all these deaths belonged to ‘complicated PPH’ category. Conclusion: Identifying a case of ‘SAMM’ from PPH is identifying a case of ‘complicated PPH’, its incidence in this study is 2.98/1000 deliveries and 31.39 for 100 cases of PPH. Identifying a case of PPH to a category ‘complicated PPH’ and prompt action on it will prevent maternal mortality from PPH. A need of additional measures to control PPH should initiate life saving protocols (a dedicated team who would arrange adequate blood, adequate laboratory support, adequate surgical skill, adequate close monitoring and if required transportation with all on the way assistance) as these are the cases which survive only if they are lucky to get good care.
Authors and Affiliations
Sushma Bhoosreddy, Rama Krishna Raj Mudam
Keywords
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