Primary Postpartum Hemorrhage: Risk Factors, Causes and Maternal Outcome

  • Rashida Sultana Associate professor Obstetrics & Gynaecology Sharif Medical & Dental College, Lahore
  • Sofia Manzoor Senior Registrar Obstetrics & Gynae Unit I Sir Ganga Ram Hospital, Lahore
  • Shamsa Humayun Head of Obstetrics & Gynae Department Sir Ganga Ram Hospital, Lahore
Keywords: Haemorrhage, Maternal Outcome, Postpartum, Risk factors


Objectives: To determine the prevalence of primary postpartum haemorrhage, its associated risk factors, causes and maternal outcome in patients with primary postpartum haemorrhage.

Methodology: The descriptive study was conducted at Sir Ganga Ram Hospital, Lahore, from 1st Jan 2013 to 30th Dec 2017. All patients with primary postpartum haemorrhage who fullfilled inclusion criteria were included in the study after informed consent.  Data was collected on a structured proforma. Data was entered and analyzed in SPSS version 23. For quantitative data like age, Parity, gestational age and Hb, mean and standard deviation was calculated. For qualitative variables like severity of Primary PPH, its associated risk factors were calculated in percent and frequency.

Results: Total number of   births during study period was 27,000 and those who developed primary postpartum haemorrhage were 202; thus prevalence of primary PPH was % 0.74. Mean age of the study participants was 26.97± 4.6 year. Severity of primary postpartum haemorrhage was mild in 154(76.2%), moderate in 44(21.8%), and severe in 4(2%) cases. Most common cause of PPH was uterine atony in168 (83.2%) patients. Maternal mortality was 3.9 % (8).

Conclusion:  The most significant risk factor for primary PPH is placenta previa and morbidly adherent placenta. The most common cause of PPH is uterine atony. Maternal mortality can be markedly reduced by active management of 3rd stage of labour with uterotonics.

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