A Clinical Study of incidence and Risk Factors for Primary Postpartum Haemorrhage at Tertiary Care Hospital

Globally, postpartum hemorrhage (PPH) is a leading cause of maternal mortality. The global prevalence PPH is 6 to 11 %. The incidence of maternal death in India due to haemorrhage are 25.6 %. Common causes of PPH are uterine atony, tissue (retained products of conception), failure of the blood coagulation system and trauma. A prospective cohort study was conducted at Umaid Hospital, Jodhpur. All the patients were diagnosed as PPH at tertiary care hospital from January 2017 to September 2017. In this study all women were included with primary postpartum hemorrhage (PPH) following pregnancy greater than24 weeks� gestation beyond with all modes of birth in any setting (hospital, birth centers, home vaginal delivery and caesarean section) was referred and at Umaid Hospital. The cross tabulations were used to study the demographic, obstetrical and medical factors in women with severe obstetrical haemorrhage. Total number of 18, 432 patients delivered during this period. Results showed that obstetrical haemorrhage was in 350 patients (incidence of 1.89 %). As 87.72 % 0f the patients in study were rural, it contributed the high prevalence rate& antenatal care. A large proportion of the patients (73.72 %) were multipara. Mortality in this study was 21.7 % and most common morbidity was postpartum anemia 98.58 %. Most common cause of obstetric haemorrhage in this study was uterine atonic pph. The frequency and impact of severe hemorrhage can be effectively reduced by reducing avoidable risk factors, especially those related to obstetric interventions as increased Caesarean section rate and induction of labor. Other risk factors not amenable to change such as age, ethnic origin, and preexisting medical diseases or bleeding disorders can be minimized by extra vigilance and planned conjoined management.