Incidence and outcome of primary postpartum hemorrhage at Zagazig University Hospitals

Abstract

Background: postpartum hemorrhage (PPH) is an obstetrical emergency that can occur after vaginal or cesarean delivery. It is the most common cause of maternal morbidity and may be complicated by shock, renal failure, acute respiratory distress syndrome, coagulopathy, and Sheehan syndrome. PPH is one of the top five causes of maternal death in both developed and developing countries. The Aim of work to assess the incidence and outcome of primary PPH in Zagazig University Hospitals to assess magnitude of the problem. Methods: This is a prospective cohort clinical study which was conducted in Zagazig University Maternity Hospital. Cases diagnosed with primary post partum haemorrage who delivered at or admitted to maternity hospital at Zagazig University Hospitals. Results: 3000 cases were admitted either delivered at our hospital or outside and admitted for immediate post partum hemorrhage, 74 cases were diagnosed by immediate post partum hemorrhage (2.5%). percentage of PPH in our study was found to be 2.5%, the most common causes of PPH are uterine atony 71.6% , obstetric trauma 18.9%, the most common risk factors for PPH are placenta previa 28.4%, PIH 21.6%, Anemia 18.9%, 10.8% experienced previous postpartum hemorrhage, the majority of the studied women had no medical problems (75%), there was significant relation between PPH occurrence and past medical history, anemia and previous PPH, the tertiary care was the commonest place for delivery followed by private (94.6% and 4.1% respectively), 49 patients received 1_5 units blood (66.2%), 50 patients have moderate degree of shock (67.5%).Conclusion: primary PPH was found to be 2.5%, most common causes of PPH are uterine atony 71.6% , obstetric trauma 18.9%.

Carbetocin versus Oxytocin: A Comparative Study to Prevent Postpartum Hemorrhage in Pre-eclamptic Women Delivered by Caesarean Section

“…Any potential for improvement in management of these two disorders should be investigated (2) . Definition of PPH is the loss of 500 ml of blood in vaginal delivery or 1000 ml in Caesarean Section (CS) from the genital tract within 24 h of the delivery of the baby (3) . It is classified as: Minor PPH (blood loss 500-1000 ml) and major PPH (more than 1000 ml).…”

Comparison of Complication and Post-Operative Infection Rate Between Application of Carbetocin and Oxytocin during Management of Post-Partum Hemorrhage after Caesarean Section

“…The difference between the mean age of group I and group II were not statistically significant (Table 1). 13 observed at baseline, there was no significant difference between carbetocin and oxytocin in terms of mean age, where mean was 30 years and 31 years respectively. The higher mean age may be due to geographical variations, racial, ethnic differences, genetic causes, different lifestyle and increased life expectancy may have significant influence in their study patients 11 .…”

“…Safety of carbetocin following vaginal births and emergency Cesarean sections has not been established, though studies have suggested efficacy following vaginal births to that following Cesarean sections 11 . Some studies have shown that a 10 to 70 μg dose following vaginal delivery caused contractions and no adverse side effects 13 . The recommended dose for an average adult female is 100 μg, administered slowly over a minute 8 .…”

Effect of moderate iron deficiency anemia during pregnancy on maternal and fetal outcome.

“…6 Another study discovered a link between PPH occurrence and prior medical history, anemia, and previous PPH. 7 According to one study, women who had wound dehiscence after a cesarean section had a high rate of anemia, and as a result of the underlying anemia, they were more vulnerable to infection. 8 A case-control study looked at the risk factors for surgical site infection after cesarean section and discovered that only 2.4 percent of women got it.…”