Analysis of surgical management of postpartum hemorrhage: At tertiary centre

Abstract

Postpartum hemorrhage (PPH) is one of the leading cause of maternal morbidity and mortality. Major blood loss of over 1000ml of blood occurs in 1-5% of deliveries. WHO statistics suggest that 25% of maternal deaths are due to PPH, accounting for more than 1,00,000 maternal deaths annually. 2 Internal Iliac Artery Ligation (IIAL) is effective method to control intractable PPH and prevent maternal mortality. In our R.L. Jalappa hospital, a tertiary referral centre, we did a retrospective study of patients who are managed for PPH between Jan 2006-Jan 2016. In our study, out of 110 PPH patients eighty of them underwent IIAL during the study period. Out of 80 IIAL cases, PPH due to uterine atony (55%), uterine rupture (23%), placenta previa (8%), placental abruption (6%), placenta increta (4%) and broad ligament hematoma (4%). Medical management was successful in 30 cases. Hysterectomy was done in 6 cases. IIAL was proved to be successful method of controlling hemorrhage in our study. We found that this is one of the best surgical method of management of PPH, so as to retain uterus thereby future fertility.