Study of management of postpartum hemorrhage and its complications

Abstract

Background: Postpartum hemorrhage (PPH) is globally one of the most common causes of maternal death, especially in developing country like India. Pregnancy and childbirth involve significant health risks, even to women with no preexisting health problem. The objective of this study was to analyze the role of various interventions in the management of PPH and its complications.Methods: This prospective observational study was conducted in the department of obstetrics and gynecology of Department of Obstetrics and Gynecology, Dr. D Y Patil Medical college, Pimpri, Pune, Maharashtra, India. A total number of 80 cases of postpartum hemorrhage that fulfilled the selection criteria were included. Data collected and analyzed in PPH patients with medical and surgical management.Results: In present study, most of cases were multigravida (60%) and more than 50 percent of patients required blood and blood products. In present study, most of the postpartum bleeding or postpartum hemorrhage (PPH) cases managed by medical methods. Uterotonic drugs (42.5%) This was possible due to early identification and timely intervention.Conclusions: Active management of third stage of labour is recommended in all cases. Seventy percent cases were managed by medical methods while rest of the cases required surgical management. Among the medical management uterotonic drugs and bimanual uterine compression was used while among the surgical methods repair of cervical and vaginal laceration was mostly required.

Study the incidence, management and outcome of primary postpartum hemorrhage in a tertiary care hospital

“…Thawal et al in an observational retrospective study had similar results in which anemia was high risk factor in 70% patients of PPH. 9 Our study shows 89% cases of primary PPH were in 37-40 weeks period of gestation whereas 11% fall between 41-42 weeks period of gestation. The reason for the same could be biologic or pathologic connections like reduced myometrial contractility (including reduced contractile response to exogenous oxytocin), altered placentation and other etiologies with risk of hemorrhage.…”

Role of the Uterine Artery Ligation (UAL) In Control of Postpartum Hemorrhage

“…In this study, the most common causes of postpartum hemorrhage were uterine atony 56.5% and adherent Placenta accreta 43.42%. However, Thawal V et al 3 reported that out of all 77.5% cases had uterine atony, 15.0% patients had perineal trauma, 5.0 seen with retained placenta and 2.5% were females had a bleeding disorder. Also, adherent placental accreta was second most common cause of PPH seen in our study.…”

“…mean age of the cases was 29.21±6.208 years with predominantly occurring in multiparous women. Similarly in the study of Thawal V et al3 reported that the average age of the females was 26.4±7.4 years and multiparous women were in majority 60%. In another study by Kebede BA et al10 demonstrated that around 83.9% of females were aged[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] …”

“…1,2 Postpartum hemorrhage is defined as the blood loss > 500ml blood loss during 24 hours after normal vaginal delivery and blood loss >1000ml after caesarean delivery. 3 In Pakistan it is the leading cause of death contributing to nearly one third of all deaths in seven years 4 , however, rates vary in different parts (9.5%, 1.6%) 5,6 , with higher rates usually seen among multiparous women than primiparous i-e; 32.4% compared with 10.6% for singletons. 1,5 To control massive or severe bleeding, a surgical approach is used by ligating uterine, ovarian artery, internal iliac artery and…”

Investigación multidisciplinaria desde una visión multidisciplinar. Libro 1

“…Almutari V, en una revisión de 71 artículos identificó la HPP como causa de mortalidad en el 27% a nivel mundial, así como una prevalencia de HPP a nivel mundial del 10%, África el 25.7%, América Latina y Asia el 8%, América del Norte 21% y en Estados Unidos fue superior el 27%. Incidiendo en Estados Unidos la HPP en la mortalidad en el 46.6% de los casos estando entre las causas principales anemia, shock hipovolémico, coagulación intravascular diseminada, déficit respiratorio agudo, insuficiencia renal y en el 70-80% la casusa más común la atonía uterina (Thawal et al, 2019).…”