Postpartum hemorrhage-related factors in a large sample of deliveries
Kemal Ayata, Emsal Pinar Topdaği Yilmaz, Ömer Erkan Yapça, Yunus Emre Topdaği and Metin İngeç
To evaluate the clinical features, risk factors, main causes, and applied surgical techniques of patients with postpartum hemorrhage. The present study included 351 patients diagnosed with postpartum hemorrhage in our clinic, during the period January 2003-December 2013. A total of 25964 women delivered during the study period. The demographic and clinical data of these patients were obtained retrospectively by medical records review. Patients transfused with at least 3 units/over whole blood and/or packed red blood cell were included in the study. Characteristic features, risk factors, causes and applied surgical techniques of patients with postpartum hemorrhage were recorded. Placental abruption in 68 patients (19,40%), placenta previa in 63 patients (17,90%), uterine atony in 57 patients (16,20%), placental insertion defects in 27 patients (7,70%), genital lacerations in 16 patients (4,60%), uterine rupture in 12 patients (3,40%) were observed as cause of postpartum hemorrhage. The performed surgical applications were hysterectomy in 52 (14,80%) patients, vaginal laceration repair in 16 (4,60%) patients, artery ligation in 13 (3,70%) patients, Bakri tamponade tamponade in 10 (2,80%) patients. Maternal mortality was observed in 15 (4.27%) of 351 patients whereas perinatal mortality was in 77 (21,90%) patients of 351 patients. Despite all the progress in modern medicine, PPH is still an important reason for both maternal and perinatal morbidity and mortality.
Keywords: Postpartum hemorrhage, postpartum hysterectomy, maternal mortality