Postpartum Hemorrhage; Incidence and Prognosis
Author(s): Zelmat SA, Bouabida D, Boucherit DE, Boucherit E, Mazour F
During the study period a total of 1000 deliveries; 74 parturients presented with PPH, an incidence of 7.4% [95% CI 6.3-6.5] with that of severe PPH at 2.7% [95% CI 1.6-1.8]. maternal age varied between 30 and 42 years. The average age in our sample was: 34.33 ± 6.030 years. Mean term: 38.69 ± 1.25 weeks gestation mean was 3.8 ± 1.6. The oldest parity was 3.2 ± 2 with extremes of 1 and 8. 73.7% were multiparous (2 deliveries and more). RBC transfusion was done in 97.5%. Oxytocics were administered in 95.8%. Uterine inertia following a placentation anomaly (accreta, increta and percreta) remains the most frequent etiology in 79.8%, and coagulation disorders 15.2% (congenital or acquired) and 5% of entangled causes (ATCD from Covid19, death in utero, help ). As for the mode of delivery, the upper route is the most frequent with 70% of cases RBC transfusion was done in 97.5%. Oxytocics were administered in 95.8%. Uterine revision was performed in 80.6%. , artificial delivery was done in 26.4%. Vascular ligation was done in 20.8%. Hemostatic hysterectomy was required in 19.4%. Hospitalization in the maternal intensive care unit was necessary in 70.9% with an average duration of 3.5 days. There were 73% cases of disseminated intravascular coagulation (DIC), 50% renal failure (IR) of which two were hemodialysis. The death rate was 18%. Three risk factors associated with a poor maternal prognosis: severe hypovolaemia (p = 0.0001), disseminated intravascular coagulation abnormalities (p = 0.006) and organic renal failure (p = 0.0013).