Clinical study on risk factors, management pattern and outcome of patients with secondary post-partum hemorrhage admitted in BSMMU

Background: Secondary postpartum hemorrhage (PPH) is a life-threatening obstetric condition. The percentage of secondary PPH is thought to be higher in developing countries. This is an important cause of maternal morbidity and mortality. Most of the patients had no identifiable risk factors and PPH cannot always be preventable. The particular cause of the hemorrhage must be investigated and treated after basic resuscitation. This study aims to evaluate risk factors, management pattern and outcome of patients with secondary PPH. Methods: This cross-sectional study was conducted in the department of obstetrics and gynaecology, BSMMU, total patients were 42 who fulfilled the selection criteria, from March 2012 to August 2012 and data were interpreted with statistical analysis. Results: Among 42 patients, 54.77% presented with identifiable risk factors, with multiple pregnancy (14.2%) and prolonged rupture of membranes (9.52%) being the most common. The leading causes were infection (54.29%) and retained placental tissue (28.57%). Most patients (59.52%) were managed medically using uterotonic drugs and antibiotics, while 23.8% required surgical evacuation of retained tissue. Blood transfusion was needed in 80.95% of cases. Favorable outcomes were observed in 97.61% of patients, with only one case of complications and no maternal deaths. Conclusions: Medical and surgical interventions for secondary PPH are effective. Prevention and early detection require strengthening of antenatal care, hygiene during childbirth and post-partum monitoring.