CAN'T WE PREVENT PRIMARYPOSTPARTUM HEMORRHAGE (PPH)?

Objective: The objective of our study is to determine the risk factors of primary post partum hemorrhage (PPH), so that its avoidable factors can be prevented. Design: Descriptive study. Place and Duration of Study: This prospective study was conducted in labour ward of Nawabshah hospital Sindh Pakistan from 5th April 2008 to 8th Dec 2008. Patients and Methods: Total of 121 patients were included in the study. Inclusion criteria were all patients admitted with or developed primary PPH in hospital after normal delivery or cesarean section. Exclusion criteria were patients with history of bleeding disorders and those on Heparin or Warfarin therapy. Patient's information was recorded on predesigned proforma. which includes sociodemographic data, mode of delivery, spontaneous, induced, delivery conducted by and risk factors for primary PPH. Assessment of general health including anemia, B.P, abdominal, pelvic examination and laboratory investigations were done. Results: A total of 121 cases of primary PPH were managed in study duration. Out of 121 patients majority 70(57.85 %) belongs to age group of 21-30 years. Regarding parity, 84 (69.42%) was grandmultipara, while 16 (13.22 %) patients were multipara. Majority of patients i.e. 71(58.67%) were unbooked, while 50(41.32%) were booked. 99(81.81%) patients were delivered in hospital. Regarding cause of PPH, uterine atony was identified as major cause seen in 98 (80.99%) of patients while genital tract injuries were seen in 23 (19%) of patients Commonest risk factor of PPH was grandmultiparity seen in 84 (69.42 %) of cases. Conclusion: Results of our study showed that unbooked, uterine atony, grandmultiparity, augmented and induced labor were commonest risk factors responsible for primary postpartum hemorrhage. [ABSTRACT FROM AUTHOR]