TITLE:
Postpartum Hemorrhage and Maternal Deaths in North East India
AUTHORS:
K. Pratima Devi, L. Ranjit Singh, L. Bimolchandra Singh, M. Rameshwar Singh, N. Nabakishore Singh
KEYWORDS:
Postpartum Hemorrhage, Maternal Mortality, Cesarean
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.11,
September
21,
2015
ABSTRACT: Hemorrhage, usually occur in the postpartum period, is responsible
between one quarter and one third of obstetric deaths. According to the world
health organization, obstetrics hemorrhage causes 127,000 deaths annually
worldwide and is the leading cause of maternal mortality. Postpartum hemorrhage
(PPH) is a frequent complication of delivery and its incidence is commonly
reported as 2% - 4% after vaginal delivery and 6% after cesarean section with
uterine atony being the cause in about 50% cases. The risk of dying from PPH
depends not only on the amount and the rate of blood loss but also the health
status of the woman. PPH remains the number one killer of mothers and accounts
about 28% of all maternal deaths in developing countries. There is an increase
risk in the PPH even in developed countries due to number of changes in recent
years. In India, Maternal mortality rate (MMR) is 212 but in the state of
Manipur (Regional Institute of Medical Sciences, RIMS), situated in the far
corner of North East MMR is 91.68 (94 maternal deaths/102525 live births during
year 2000-2010). Out of 94 deaths, 53.19% died due to hemorrhage and PPH
accounts about 21.27% of total deaths. Again, almost all these PPH died within
the first 24 hours of admission. High parity and home delivery brought late due
to varied reasons with preexisting anemia are the common problems on analysis
of maternal deaths due to PPH in our set up. Whatever the cause, death should
be preventable and outcome is largely dependent upon timely interference and
efficiency and vigor of medical practitioners. A pregnant woman and her family
must understand the risks involved in each pregnancy. Even with different
interventions and blood transfusion facility, maternal deaths cannot be brought
down to zero. But the best available health care facilities should be made
available to all.