Evaluation of Patients with Postpartum Hemorrhage Patients in a University-Affiliated Tertiary Care Hospital

Aim: To retrospectively evaluate patients with postpartum hemorrhage (PPH) and to report the incidence, indication, and complications of PPH-related hysterectomies. Methods: We evaluated medical records of patients who received the diagnosis of in a university-affiliated tertiary care hospital between February 2013 and September 2014. Results: A total of 1724 deliveries were included in the study. 36 deliveries (2.08%) were complicated with PPH. PPH was found to result from the following conditions; uterine atony (n=19), placenta previa (n=8), vaginal lacerations (n=7), and coagulation disorders (n=2). A total of 7 patients (19.4%) with PPH, of whom two had uterine atony and five had placenta previa, underwent hysterectomy (4.06 per 1000 births). Application of B-Lynch uterine compression suturing and hypogastric artery ligation did not stop PPH in two patients with atony after primary caesarean section. Balloon tamponade was successful in 71.4% of patients with placenta previa. The most common complication among hysterectomy patients was admission to intensive care unit. Conclusion: Despite the improvements in conservative management strategies, our hysterectomy rate was higher than the reported literature. We conclude that management options should be individualized according to diagnosis, hemodynamic stability of patients and also facilities of the medical centre.