Risk Factors, Causes and Management of Primary Post-Partum Hemorrhage at POF Hospital Wah Cantt

Abstract

Objective: This study aimed to assess the causes, frequency, risk factors, and treatment options for primary postpartum hemorrhage (PPH) in women at POF Hospital Wah Cantt.

Methodology: A descriptive study was conducted in the Department of Obstetrics and Gynecology at POF Hospital from January 1st to December 31st, 2021. Both booked and unbooked patients aged 21 to 42 years were included. Data regarding risk factors, causes, and management were collected from labor ward and operation theater registers using a designed Performa.

Results: Among 2600 deliveries, 80 cases (3.076%) experienced primary PPH. No maternal deaths were attributed to PPH during the study period. The majority of patients were between 24 and 29 years old (50%), and 56.25% were multigravidas. Uterine atony was the primary cause of PPH (47.5%), followed by perineal trauma, cervical tears, and vaginal tears (40%). Surgical interventions included uterovaginal packing (20%) and stitching of perineal tears (40%). Manual removal of retained placenta (12.5%) and peripartum hysterectomy (5%) were also performed. Antenatal anemia affected 22.5% of cases.

Conclusion: Uterine atony was the prevailing cause of primary PPH, with antenatal anemia being a prominent risk factor. Identifying high-risk patients and effectively managing labor's third stage can mitigate PPH occurrences. Enhanced literacy, nutrition, iron supplementation, and accessible healthcare facilities are crucial for minimizing severe morbidity.