A Study to decrease the incidence of PPH in our hospital setting

  • Neelima Agrawal Consultant, Department of Obstetrics and Gynaecology, Agrawal Hospital, Bhopal, Madhya Pradesh, India
  • Dr. P. N. Agrawal Consultant Respiratory and Critical care, Agrawal Hospital, Bhopal, Madhya Pradesh, India
Keywords: Postpartum haemorrhage (PPH), Maternal mortality, Uterotonic agents, B –lynch suture


Objective: This study aimed to measure incidence, identify risk factors (pre‐existing or acquired) for PPH and to prevent progression to severe PPH.

Methods: This is a prospective observational study. The causes are likely to be multifactorial with shifting demography and health status widely cited, e.g. age, obesity, comorbidity, multiple pregnancy and ethnicity.

Results: Prepregnancy factors for PPH include age, ethnicity, BMI, previous PPH and assisted conception

Conclusion: Prophylactic uterotonic agents in high-risk patients, use of intramuscular or intravenous oxytocin, timely application of B –lynch suture, adequate and timely arrangement of blood and blood factors can help prevent PPH.


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Buzaglo N, Harlev A, Sergienko R, Sheiner E. Risk factors for early postpartum hemorrhage (PPH) in the first vaginal delivery, and obstetrical outcomes in subsequent pregnancy. J Matern Fetal Neonatal Med. 2015 May;28(8):932-7. doi: 10.3109/14767058.2014.937698.

Briley A, Seed PT, Tydeman G, Ballard H, Waterstone M, Sandall J, et al. Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study. BJOG. 2014 Jun;121(7):876-88. doi: 10.1111/1471-0528.12588.

Gallos ID, Papadopoulou A, Man R, Athanasopoulos N, Tobias A, Price MJ, et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev. 2018 Dec 19;12(12):CD011689. doi: 10.1002/14651858.CD011689.pub3.

Gilbert L, Porter W, Brown VA. Postpartum haemorrhage--a continuing problem. Br J Obstet Gynaecol. 1987 Jan;94(1):67-71. doi: 10.1111/j.1471-0528.1987.tb02255.x.

Sheiner E, Sarid L, Levy A, Seidman DS, Hallak M. Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study. J Matern Fetal Neonatal Med. 2005 Sep;18(3):149-54. doi: 10.1080/14767050500170088.

Magann EF, Evans S, Hutchinson M, Collins R, Howard BC, Morrison JC. Postpartum hemorrhage after vaginal birth: an analysis of risk factors. South Med J. 2005 Apr;98(4):419-22. doi: 10.1097/01.SMJ.0000152760.34443.86.

Joshi VM, Otiv SR, Majumder R, Nikam YA, Shrivastava M. Internal iliac artery ligation for arresting postpartum haemorrhage. BJOG. 2007 Mar;114(3):356-61. doi: 10.1111/j.1471-0528.2006.01235.x.

McCormick ML, Sanghvi HC, Kinzie B, McIntosh N. Preventing postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet. 2002 Jun;77(3):267-75. doi: 10.1016/s0020-7292(02)00020-6.

Tort J, Rozenberg P, Traoré M, Fournier P, Dumont A. Factors associated with postpartum hemorrhage maternal death in referral hospitals in Senegal and Mali: a cross-sectional epidemiological survey. BMC Pregnancy Childbirth. 2015 Sep 30;15:235. doi: 10.1186/s12884-015-0669-y.

Grönvall M, Tikkanen M, Tallberg E, Paavonen J, Stefanovic V. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand. 2013 Apr;92(4):433-8. doi: 10.1111/j.1600-0412.2012.01531.x.

Karoshi M, Keith L. Challenges in managing postpartum hemorrhage in resource-poor countries. Clin Obstet Gynecol. 2009 Jun;52(2):285-98. doi: 10.1097/GRF.0b013e3181a4f737.

Marshall AL, Durani U, Bartley A, Hagen CE, Ashrani A, Rose C, et al. The impact of postpartum hemorrhage on hospital length of stay and inpatient mortality: a National Inpatient Sample-based analysis. Am J Obstet Gynecol. 2017 Sep;217(3):344.e1-344.e6. doi: 10.1016/j.ajog.2017.05.004.

Abrams ET, Rutherford JN. Framing postpartum hemorrhage as a consequence of human placental biology: an evolutionary and comparative perspective. Am Anthropol. 2011;113(3):417-30. doi: 10.1111/j.1548-1433.2011.01351.x.

Karoshi M, Keith L. Challenges in managing postpartum hemorrhage in resource-poor countries. Clin Obstet Gynecol. 2009 Jun;52(2):285-98. doi: 10.1097/GRF.0b013e3181a4f737.

Kwast BE. Postpartum haemorrhage: its contribution to maternal mortality. Midwifery. 1991 Jun;7(2):64-70. doi: 10.1016/s0266-6138(05)80229-3.

Knight M, Callaghan WM, Berg C, Alexander S, Bouvier-Colle MH, Ford JB, et al. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth. 2009 Nov 27;9:55. doi: 10.1186/1471-2393-9-55.

DOI: 10.17511/joog.2021.i04.01
Published: 2021-08-31
How to Cite
Neelima Agrawal, & Dr. P. N. Agrawal. (2021). A Study to decrease the incidence of PPH in our hospital setting. Obs Gyne Review: Journal of Obstetric and Gynecology, 7(4), 35-41. https://doi.org/10.17511/joog.2021.i04.01
Original Article