Postpartum hemorrhage -- clinical profile and referral patterns in a tertiary care teaching institution in south Kerala, India

• Author Details:   
• Lisha Lakshman
• Adma Harshan
• Heera Trivikrama Shenoy ^*
• Ranjana B
• Simi Jameela

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Aim and Objective: The aim of the present study was to review the maternal records of cases of PPH and to evaluate the clinical profile, risk factors & referral patterns associated with PPH at our tertiary care centre

Materials and Methods: A hospital record based retrospective study was conducted in obstetrics & gynecology department, Government Medical college Thiruvananthapuram & women who gave birth after 28 weeks of gestation who had PPH after normal vaginal delivery or caesarean between January 2019 and January 2021 were the participants.

Results: In the present study 31.9% with PPH were from 26- 30yrs. Majority (58%) of the study population were booked cases and 67.2% of study participants had regular antenatal visits. 78.1% of the referred cases had received proper initial emergency management of PPH before referring to tertiary centre, which might be attributed to introduction of regular training programmes of KFOG like EMOCALS workshop, ORRT, MDNMSR. Anaemia (34.4%) and GHTN (20.1%) were the common risk factors among pph patients. Out of 119, 55% had minor PPH. Atonic PPH was the major cause of PPH (52.5%) followed by traumatic PPH (30.8%) which in majority were managed medically Near- miss were 21% and 3.4% of mothers succumbed to death.

Conclusion: Post-partum haemorrhage is a leading cause of maternal mortality and morbidity especially in developing countries. Correcting the avoidable risk factors, active management of 3rd stage of labour and promote institutional deliveries are key steps in preventing PPH. Timely referral, regular training of the health care workers to tackle obstetric emergencies is crucial and mandatory to reduce the maternal mortality due to obstetric haemorrhage.