Evaluation of different techniques for management of postpartum hemorrhage.

Abstract

BACKGROUND : Postpartum hemorrhage accounts for a quarter of maternal deaths worldwide. Although
maternal mortality has decreased in the developed world over the years due to institutional deliveries, improved
surgical techniques and availability of blood and blood components, PPH still remains a leading cause of maternal
mortality.
MATERIAL AND METHOD: This study includes patients who developed PPH following their delivery at tertiary
care center (Sheth L. G. Hospital ) from 1stAugust 2016 to 31st July2018 in Obstetrics and Gynecology
department. During this period there were total 14798 deliveries and 55patients developed PPH.
RESULTS : In present study, 67.28% patients were unregistered and 32.72% were registered patients. In present
study, 92.72% Patients were delivered at hospital and 7.28% were delivered at home. In present study, 61.82%
patients with cesarean sections and 38.18% with vaginal delivery were having PPH. 85.46% patients developed
atonic PPH,14.55% traumatic, 5.45% associated with coagulopathy..In 49.09% of patients operative intervention
required in form of uterine artery ligation (27.27%), Ovarian Artery Ligation (3.64%), uterine compression
sutures(3.64%), tear suturing(9.09%), obstetric hysterectomy(10.91%). Maternal mortality was 3.64%.
CONCLUSION: PPH is preventable condition. By identifying risk factor and anticipating PPH we can prevent and
manage PPH. Thus intelligent and anticipatory early interventions with proper planning are required to reduce the
mortality and morbidity in PPH. Active management of labour, especially the third stage with routine prophylactic
administration of uterotonic drugs to reduce the risk of PPH have become an integral part of the management of
labour and delivery.