Title: Post-Partum Hemorrhage- What is the Vital Back up in a Government Tertiary Care Institution
Authors: Dr Divya Yadav, Prof. Shikha Singh, Dr Rekha Rani, Dr Ragini Singh
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.16
Abstract
Introduction
Severe Obstetric hemorrhage is the most dreaded obstetric emergency. The most common type of obstetric hemorrhage is post-partum hemorrhage (PPH). PPH remains a foremost cause of maternal mortality and morbidity worldwide.PPH occurs in 5% of all deliveries, majorities of death occur within four hours of delivery indicating that it is a consequence of the third stage of labour[1]. Further, It’s a major challenge in developing countries with aprojected mortality rate of 140,000 annually or one death every four minutes[2]. WHO estimates 5,29,000 maternal deathsevery year, India contributes to 25.7% of worldwide maternal mortality (1,36,000 maternal deaths/year). Two third of these maternal deaths occur post-delivery, PPH is the most frequently stated complication[3] and occurs generally without any warning signs or symptoms and commonly not associatedwith predisposing factors. The common causes of PPH are uterine atony, retained placenta, and trauma. Placental Anomalies, Abruptioplacentae, and uterine rupture are less common but frequentlyaccountable for severe PPH with acquired coagulopathy. The inadmissibly high maternal mortality of 540 per 100,000 live births in India in past decades remains a major challenge[3]. Most of the time, these deaths due to obstetric hemorrhage are preventable[4,5]. An understanding of the size of the problem, associated risk factors and consequence of PPH would help to improve both preventive and curative healthcare services. This retrospective cohort study is intended to identify the prevalence, associated risk factors and outcomes of various treatment strategies to manage PPH in an Indian tertiary Healthcare Centre.
