A RETROSPECTIVE STUDY ON SECONDARY POSTPARTUM HAEMORRHAGE IN A TERTIARY CARE MATERNITY HOSPITAL

Ufaque Muzaffar* and Farhat Jabeen

ABSTRACT

ABSTRACT Introduction: Postpartum haemorrhage is one of the leading causes of maternal mortality both in developing and developed countries. Although primary PPH is studied a lot but data regarding secondary PPH is sparse. Aims and objectives: Objective of our study was to find the incidence, causes and outcome of patients of secondary PPH. Methods: A retrospective study was carried out in Lalla Ded Hospital, GMC Srinagar over a period of 2 years from January 2016 to December 2018. Results: sixty two patients with secondary PPH were studied out of whom 72% were delivered vaginally. Maximum patients belong to age group of 20-28 years and 43% were P1. Retained products of conception was the leading cause in 68% of patients followed by endometritis in 21%. Mean haemoglobin concentration was 8.2+1.5g. curettage was done in 61% of patients. 18 patients required blood transfusion. Hysterectomy was done in 1 patient. None of the patient died. Conclusions: Secondary PPH is an important cause of maternal morbidity and mortality. Basic resuscitation followed by investigation and treatment of the specific cause can reduce the morbidity and mortality. Retained products of conception were a leading cause of secondary PPH in our study which is probably related to poor management of third stage of labour. It signifies that there is crucial role of active management of third stage of labour in preventing secondary PPH. Our study confirms that primary PPH is a risk factor for secondary PPH, so every effort should be made to prevent primary PPH. If medical intervention is sought early prognosis can be improved.

Keywords: Secondary postpartum haemorrhage, risk factors, outcome, maternal morbidity, management.