Incidence, Management and Outcome of Atonic Postpartum Haemorrhage at Tertiary Care Hospital

Abstract

Aim: To study incidence, management and outcome of atonic postpartum haemorrhage. Methods: Cross sectional study design. Analysis of delivery data of one year at Pravara Rural Hospital. Results: There were 116 cases of atonic PPH. The incidence of atonic PPH was 0.88 percent. Atonic PPH was more in caesarean deliveries as compared to vaginal deliveries. It was more in emergency caesarean sections as compared to elective caesarean. There were 54 cases (46.55%) of mild PPH, who were successfully managed by medical methods. Uterine balloon tamponade was used in those cases who did not respond to medical management (31.89%). Surgical intervention in the form of either B Lynch suture or stepwise devascularisation including internal iliac ligation was performed in 5 cases and obstetric hysterectomy was required in 20 cases. There were two maternal deaths among 116 cases of atonic PPH. Conclusion: Atonic Postpartum haemorrhage is common among high risk pregnancies. Institutional deliveries will help in preventing and managing this complication in a effective manner. Facility Preparedness in all respect will prevent deaths due to atonic PPH. The incidence can be lowered by universal adoption of AMTSL. Wise and prompt decisions regarding use of different modalities or combination of modalities will save lives.