PREVALENCE AND ASSOCIATED RISK FACTOR OF POSTPARTUM HEMORRHAGE IN TERTIARY CARE HOSPITAL OF PAKISTAN. A CROSS-SECTIONAL STUDY
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Keywords
Postpartum Hemorrhage, Prevalence, Anemia, C-Reactive Protein (CRP), Inflammatory Markers, Antenatal Assessment, Tertiary Care Hospitals, Maternal Morbidity
Abstract
Background: Postpartum hemorrhage (PPH) continues to be a significant contributor to maternal illness and death, particularly in resource constrained regions. This research aimed to determine the occurrence and contributing factors of PPH among women who recently gave birth in tertiary level hospitals across Pakistan.
Methods: A descriptive, cross-sectional study was conducted at two major healthcare centers Lahore General Hospital, Ameer Ud Din Medical College, Lahore and Gulab Devi Hospital, Al Aleem Medical College, Lahore in Obstetrics and Gynaecology Department. Using a systematic random sampling approach, data were collected from 135 postpartum patients who had complete clinical documentation. Information retrieved retrospectively included sociodemographic, obstetric background, medical history, and laboratory indicators such as hemoglobin concentration, inflammatory markers, and clotting profiles. Data were analyzed using SPSS v26, with chi-square tests and logistic regression employed to isolate predictors of PPH. A p-value of less than 0.05 was deemed statistically significant.
Results: The overall occurrence of PPH was observed in 9.6% of the sampled cases. Among women with no fetal loss, those aged 36 years or above, with previous multiple pregnancies, labor exceeding 17 hours, low hemoglobin levels (under 10.5 g/dL), and raised Creative protein (CRP >12 mg/L) showed a higher likelihood of developing PPH. Notably, women experiencing extended labor had 2.8 times greater odds of encountering PPH (OR = 2.8; 95% CI: 1.6–5.2; p = 0.001).
Conclusion: The study underscores that PPH stems from a blend of clinical and demographic determinants. Focus antenatal assessment timely anemia management surveillance of labor duration and inflammatory screening could serve as critical strategies to mitigate the incidence of PPH and enhance maternal health outcomes.
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Amna Javed
Assistant Professor, Obstetrics and Gynaecology Department, Al Aleem Medical College, Lahore.
Nusrat Lakho
Associate Professor, Obstetrics and Gynaecology Department, Al-Tibri Medical College, Isra University, Karachi Campus
Rabbiya Sarwar
Assistant Professor, Community Medicine Department, Rashid Latif Medical College, Lahore.
Saira Fayyaz
Associate Professor, Obstetrics and Gynaecology Department, Ameer Ud Din Medical College, Lahore.
Syma Arshad
Associate Professor, Community Medicine Department, Rashid Latif Medical College, Lahore.
Asma Kanwal
Assistant Professor, Community Medicine Department, Rashid Latif Medical College, Lahore.