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POSTPARTUM HEMORRHAGE (PPH)

Keywords: PPH , Risk Factors , Mortality

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Abstract:

OBJECTIVES: 80 cases of PPH were analyzed retrospectively to assess the risk factor association, modeof treatment and outcome. STUDY DESIGN: Retrospective study. PERIODS: 02 years, from June 1999to May 2002. SETTING: Peoples Medical College Hospital, Nawabshah. PATIENTS & METHODS: 180cases of PPH were analyzed, keeping in view their age, parity, booking status, mode, type and place ofdelivery. The efficacy of obstetric care was assessed by maternal morbidity and mortality related to PPH andits treatment. RESULTS: Out of 180 patients with PPH, 117 (65 %) were referred cases while 63 (35 %)were delivered at PMCH Nawabshah. Risk factors identified were increasing maternal age, grand multiparity, lack of antenatal care, operative and instrumental deliveries. Underlying pathology was uterine atony68.33 %, retained product of conceptions 20.55 %, GT. injuries 8.33 % and D.I.C 2.77 %. Out of 180patients, 71.11 % patients gave response to medical treatment, 20.55 % needed evacuation of uterus. Uterinepacking done in 15.55 % of cases and simple repair of GT. injuries done in 6.66 %. Obstetricalhysterectomies account for 10 % of cases. Complications in operated patients were paralytic ileus in 6.66%. chest infection 5.55 %. DVT in 1.11 % and pelvic infection in 5.55 % patients. During study period, 72maternal deaths occurred and PPH contributed 31.94 % of it. CONCLUSION: The study revealed that aneffective ante, intra and postpartum care, blood bank facilities and an alert action by Obstetric team are veryimportant in prevention of mortality and mobility of this challenging problem. Training of resident surgeonsand early involvement of skilled and senior personnel are needed to eliminate the substandard care and toreduce the large number of abdominal hysterectomies which were carried out in present series.

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