A Prospective Study to Evaluate the Risk Factors and Effectiveness of Management Strategies in Postpartum Hemorrhage

Introduction: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide, particularly in low-resource settings where access to quality obstetric care is limited. Uterine atony is the primary cause of PPH, accounting for most cases, especially in developing countries. Early identification of risk factors and timely intervention are crucial to preventing severe outcomes. This study aims to evaluate the risk factors associated with PPH and assess the effectiveness of different management strategies in reducing morbidity and mortality. Materials and Methods: This prospective study was conducted at Shri M. P. Shah Medical College, Jamnagar, from November 2022 to November 2023, including 52 patients diagnosed with PPH. Patients were identified through hospital admissions and referrals from surrounding health centers. Data were collected through patient interviews, medical records, and clinical observations, focusing on obstetric history and known risk factors such as prolonged labor and multiple gestations. Management strategies, including medical treatments, uterine massage, surgical interventions, and blood transfusions, were evaluated for effectiveness based on patient outcomes. Results: In our study, 71.43% of patients were multiparous, and most (71.43%) were aged 24-30 years. Anemia was the most common high-risk factor (30.15%), followed by prolonged labor (12.69%) and preeclampsia/eclampsia (6.34%). Atonic PPH was the leading cause (52.70%), with traumatic causes like cervicovaginal tears at 28.38%. Medical management was the most frequently used treatment (38.10%), followed by uterine packing (25.40%) and vessel ligation (12.70%), with obstetric hysterectomy reserved for severe cases (6.35%). Conclusion: The prevalence of multiparity and anemia as key risk factors for postpartum hemorrhage (PPH), with atonic PPH being the most common cause. Early identification and a stepwise management approach, starting with medical interventions, are essential in improving outcomes for affected patients.