FREQUENCY OF POSTPARTUM HAEMORRHAGE IN MATERNAL MORTALITY IN A TERTIARY CARE HOSPITAL

Abstract

Objectives: To determine the frequency of postpartum haemorrhage as a cause in maternal mortalityduring a period of seven years in a tertiary care hospital.Methodology: This descriptive study was conducted in Gynae A unit of Department of Obstetrics andGynecology, Lady Reading Hospital Peshawar. Data was collected from maternal mortality recordsst st retrospectively from 1 January 2003 to 31 December 2009. All patients who died in the hospital with adiagnosis of postpartum haemorrhage as the primary cause of death were included in the study.Results: A total of 302 maternal deaths were recorded during the study duration. Out of these 302, 74were due to Post-partum Haemorrhage which constituted 24.5% of maternal deaths. The mean age of thesample was 29.69+7.10. Uterine atony was the cause of death in 45.9%(n=34), rupture uterus in32%(n=24), genital tract tears in 14.86%(n=11) and retained placenta in 6.75%(n=5) of the cases of PostpartumHaemorrhage. Subtotal abdominal hysterectomy was performed in 51.35%(n=38); repair of tearsand removal of placenta in 6.75%(n=5) each; Subtotal abdominal hysterectomy with internal iliac ligationwas performed in 5.4%(n=4) cases while only internal iliac ligation and B Lynch suture was applied in1.35%(n=1) each. The remaining 20 cases expired before they could be prepared for it.Conclusion: Postpartum Haemorrhage was found to be leading cause of maternal mortality making up toone quarter of total deaths in 7 years. Uterine atony and ruptured uterus were the major causes ofPostpartum Haemorrahge. Subtotal abdominal hysterectomy was the major procedure performed.