Clinicodemographic Risk Factors and Maternal Outcomes Associated with Primary Postpartum Hemorrhage. A Prospective Observational Study
Risk Profile of Primary Postpartum Hemorrhage
DOI:
https://doi.org/10.69750/dmls.03.01.0185Keywords:
Primary postpartum hemorrhage, uterine atony, mother outcome, anemia, multiparity, obstetric risk factorsAbstract
Background: Primary postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, particularly in developing countries. Early identification of clinicodemographic risk factors is essential for prevention and improved maternal outcomes.
Objective: To assess the clinicodemographic risk factors and maternal outcomes associated with primary postpartum hemorrhage in a tertiary care hospital.
Methods: This prospective observational study included 100 women who developed primary PPH within the first 24 hours after delivery. Primary PPH was defined according to World Health Organization criteria. A structured proforma was used to document sociodemographic characteristics, obstetric risk factors, causes of PPH, and maternal outcomes. Data were analyzed using SPSS version 26. Chi-square or Fisher’s exact tests were applied to evaluate associations between risk factors and adverse maternal outcomes, with a p-value <0.05 considered statistically significant.
Results: The mean maternal age was 29.4 years. Major risk factors identified were multiparity (62%), anemia (61%), and rural residence (65%). Cesarean delivery accounted for 44% of cases. Uterine atony was the most common cause of PPH, responsible for 72% of cases. Maternal outcomes included the need for blood transfusion (68%), surgical intervention (19%), ICU admission (15%), and hysterectomy (4%). Maternal mortality was reported in 2% of cases. Anemia, multiparity, cesarean delivery, and prolonged labor showed significant associations with severe maternal outcomes (p ≤ 0.05).
Conclusion: Primary postpartum hemorrhage is strongly associated with modifiable clinicodemographic factors, particularly anemia, multiparity, and inadequate prenatal care. Early risk stratification, correction of maternal hemoglobin levels, and timely obstetric intervention are crucial to reducing severe morbidity and mortality. Strengthening antenatal care and ensuring optimal emergency obstetric preparedness remain key strategies for improving maternal health outcomes.
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