title: Postpartum haemorrhage: a cause of maternal morbidity.
abstract: To identify and analyse the risk factors associated with postpartum haemorrhage (PPH) and assess their impact on the maternal morbidity, a prospective observational study was carried out over a period of one year in a tertiary level referral institute in Kolkata, West Bengal, India. All the cases of PPH were identified and studied. Data analyses were done using Chi-square test. Out of 210 cases of maternal morbidity, 79 (37.6%) were found to have PPH as the causative factor. Uterine atonicity was found to be the main cause leading to 45 cases (56.9%) of PPH. With respect to the mode of delivery severe PPH was found in 34.3% of vaginally and 60% of operatively delivered patients which had statistical significance. More number of severe PPH cases, 17/31 (54.8%), had delivered outside the medical college. Here comes the role of 24-hour quality emergency obstetric care (EMOC), active management of 3rd stage of labour and early referral to the higher centre. The case fatality rate of PPH during the study period was 7.5%. This finding is quite close to the observation made in a North Indian tertiary hospital based study. In order to reduce maternal morbidity and thereby indirectly maternal mortality and to improve the overall maternal health, prevention and control of PPH can play a significant role. An integrated approach at all levels of healthcare delivery system, active management of labour and efficient emergency obstetric care will help in controlling the PPH.
authors.affiliation: Department of Obstetrics and Gynaecology, Calcutta Medical College, Kolkata 700073.
authors.forename: Hasibul Hasan
authors.initials: HH
authors.lastname: Shirazee
authors.forename: Sudip Kr
authors.initials: SK
authors.lastname: Saha
authors.forename: Indrani
authors.initials: I
authors.lastname: Das
authors.forename: Tanmoy
authors.initials: T
authors.lastname: Mondal
authors.forename: Sandip
authors.initials: S
authors.lastname: Samanta
authors.forename: Moloy
authors.initials: M
authors.lastname: Sarkar
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors