MATERNAL OUTCOMES IN POSTPARTUM HEMORRHAGE AFTER CESAREAN SECTION

Abstract

Objective: to determine the frequency of maternal outcomes in postpartum hemorrhage after cesarean section at a tertiary care hospital

Study design: Descriptive study

Place and duration of study: Department of Obstetrics & Gynecology, Unit-IV, Liaquat University of Medical and Health Sciences Jamshoro, over a period of one year from March 2024 to February 2025.

Methodology: A total of 114 women develop PPH after cesarean within 24 hours had age between 18 – 45 years, gestational age >28 weeks, irrespective of parity, both booked and un-booked cases were included via non-probability sampling technique. Women were included either through emergency or outpatient department. Patients with cardiac diseases, diabetes mellitus, chronic kidney diseases, with history of bleeding disorder and taking therapeutic anticoagulants were excluded from the study. After taking the baseline data, women were evaluated for the maternal outcomes of PPH after cesarean section. Data was analyzed with the help of SPSS version 27.0. Mean + SD was reported for quantitative data, whereas, frequency and percentages were computed for qualitative data.  Stratification was done to control the effect modifiers. Post-stratification Chi-square test was applied. P-value < 0.05 was taken as significant.

Results: The mean age of the women enrolled in this study was 26.31 + 4.45 years, mean BMI was 25.46 + 2.42 kg/m² and mean gestational age was 38.03 + 1.45 weeks. 49 (42.9%) were primigravida and 65 (57.1%) were multigravida. 44 (38.6%) had previous C-section and women were rural resided 16 (14%). Maternal outcomes in women with postpartum hemorrhage after cesarean section were assessed, most frequent outcome which was observed in this study was anemia 79 (69.2%) followed by hypovolemic shock 23 (20%), hysterectomy 2 (1.75%) and acute renal failure 2 (1.75%) each.

Conclusion: We noted a high rate of anemia in women who developed PPH after C-section in this study. Addressing anemia during pregnancy and further research in this area are recommended to improve maternal outcomes