Year: 2026 | Month: January | Volume: 16 | Issue: 1 | Pages: 101-109
DOI: https://doi.org/10.52403/ijhsr.20260113
A Prospective Observational Study on Incidence, Etiology, Maternal Risk Factors, Management and Outcomes of Postpartum Haemorrhage in a Tertiary Care Hospital
Deeksha Singh1, Deepti Rana2, Ashok Verma3
1Resident Doctor, Department of Obstetrics and Gynecology, Dr Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
2Assistant Professor, Department of Obstetrics and Gynecology, Dr Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
3Professor & Head of Department, Department of Obstetrics and Gynecology, Dr Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
Corresponding Author: Dr. Deeksha Singh
ABSTRACT
Background: Postpartum haemorrhage (PPH) is the most life- threatening complication responsible for 140,000 death per year, 26.5% occurring in developing country like India. In India, PPH incidence is 2-4% following vaginal delivery and 6% following caesarean section. Despite advancements in obstetric care, PPH continues to present significant clinical challenges due to its unpredictable nature and rapid progression.
Objective: This study aims at evaluating the incidence, etiological factors, associated maternal risk factors, management modalities and maternal outcomes of PPH in a tertiary care hospital.
Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology at Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, from 4 April 2024 to 3 April 2025. All women who developed PPH after vaginal delivery or caesarean section and who consented to participate in the study were included. Data on demographics, causes of PPH, risk factors, management strategies (medical and surgical), and outcomes were analyzed using descriptive statistics.
Results: Among 7,687 deliveries, 100 cases developed PPH, yielding an incidence of 1.3%. The most common cause was uterine atony (39%), followed by trauma (17%), multifactorial causes (15%), retained placenta (10%), placenta previa/accreta (9%), and coagulation disorders (10%). Major risk factors included hypertensive disorders of pregnancy (12%), anaemia (10%), previous caesarean delivery (9%), postdated pregnancy (9%), and multifetal gestation (8%). Medical management formed the first line of treatment, with uterotonics used in all cases. Surgical interventions included cervicovaginal repair (33%), compression sutures (15%), arterial ligation (12%), balloon tamponade (10%), and hysterectomy (1%). Maternal outcomes showed that 78% required blood transfusion, 30% required ICU/HDU admission or resuscitative measures, 24% had prolonged hospital stay and 9% developed shock. No maternal deaths occurred during study.
Conclusion: PPH remains a major obstetric emergency requiring prompt diagnosis and a multidisciplinary approach. Identification of high-risk cases, early initiation of uterotonic therapy, and timely escalation to surgical interventions are crucial to improving maternal outcomes. Strengthening antenatal care, early referral, and adherence to standardized PPH protocols can further reduce morbidity.
Key words: Postpartum Hemorrhage, Previous CS, Incidence, Causes, Atonic PPH, HDP..