Abstract:
Obstetric Haemorrhage is one of the leading cause of maternal mortality and morbidity. This prospective observational study was carried out in the department of the Obstetrics and Gynaecology, Sir Ganga Ram Hospital Lahore to evaluate the prevalence of O.H and mortality and morbidity associated with it. A total number of 3353 patients were delivered in the said unit during the study period. Two hundred and four (6.08%) patients had obstetric haemorrhage. Major O.H described as a loss greater than 1500 ml of blood was observed in 48 (1.43%) patients. Antepartum haemorrhage (APH) was present in 105 (51.47%) patients and Postpartum haemorrhage (PPH) was seen in 79(38.72%) patients. Eleven patients (5.4%) had intrapartum haemorrhage, 9 (4.4%) had both APH and PPH. Major cause of APH was placentae praevia which accounted for 52.63%(60) of the cases followed by abruptio placentae which was responsible for APH in 38.60%(44) of the patients . Uterine atony was the leading cause of PPH (50%) followed by PPH caused by traumatic lesions of the genital tract and placenta related causes. Majority of the patients were grand multipara (43.00%) , illiterate and belonged to low socioeconomic group. Out of the total number of 7 maternal deaths 2 deaths were caused each by ruptured uterus, abrubtio placentae and coagulopathy. Uterine atony was the cause of one maternal death. The incidence of death increased with the increase in the time duration prior to admission to hospital. Hypovolemic shock and DIC were the two main causes of early maternal morbidity seen in 23.5% and 8.3% of patients respectively. Late maternal morbidity was caused mainly by anemia (67.15%), febrile illness (26.47%, paralytic ileus (8.82%) and wound dehiscence (6.86%). Out of 204 patients with O.H; 111 had normal vaginal delivery, 72 underwent caesarian section. Eight (3.92%) patients had obstetric hysterectomy, 5 of them were done for uterine atony, 2 for ruptured uterus and one for placenta percreta. The stay in hospital was naturally longer in the patients having surgical intervention. Foetal morbidity and mortality was more frequent in patients with O.H. Prematurity was seen in 44.91%, perinatal deaths in 43.2% and foetal distress in 16.10% of cases.
Page(s):
153-157
DOI:
DOI not available
Published:
Journal: Pakistan Postgraduate Medical Journal, Volume: 14, Issue: 4, Year: 2003