RISK FACTORS FOR PRIMARY POSTPARTUM HEMORRHAGE

Abstract

Objectives: To describe the associated risk factor for primary Postpartum Hemorrhage (PPH) and
its severity with increasing parity and duration of labour. Design: It was a descriptive study. Place and duration of
study: The Department of Obstetrics & Gynecology (Unit II) of Bahawal Victoria Hospital, Bahawalpur from January
2004 to December 2004. Patient and method: Fifty patients with primary postpartum hemorrhage were included in
this study. Data was collected from the patients through a structured proforma. The variable studied were parity,
duration of labour and risk factors for primary PPH. The results were statistically analyzed, chi-square test was applied
to find out the significance of parity and duration of labour and their relationship with severity of PPH. Simple
percentages were used to find associated risk factor for primary PPH. Results: The frequency of primary PPH in
primary para was 24% (12 patients) and in multi para was 76%(38 patients). Severity of PPH increased with increasing
parity (P<.05). After merging the variable of parity severity of PPH increased in patients with prolonged labour in
normally delivered patients (P<.05). As for as risk factors are concerned 60% had uterine atony while 16% got cervical
tear and the same number had retained placenta, 8% had preneal tear, Uterine inversion was seen in 6%, 4%
presented with polyhydrominos, same with placenta previa type-1. 4% had vaginal laceration, 2% had DIC and 2%
had abruptio placenta. Conclusion: The result of the study revealed a number of associated risk factors for primary
PPH and proved the relationship of its severity with increasing parity and duration of labour. Duration of labour had a
significant relationship with PPH even in Primipara.