Reducing Maternal Mortality through Effective Management of Postpartum Haemorrhage – A Prospective Study from a Tertiary Care Facility in Bangladesh

Open Access

Abstract

Background: Postpartum haemorrhage remains a leading cause of maternal mortality in Bangladesh; effective tertiary care management is crucial. This study aims to analyse the effective management of postpartum haemorrhage in the reduction of maternal mortality and morbidity in a tertiary care hospital of Bangladesh. Methods & Materials: The prospective cross-sectional study was conducted from 1 July 2010 to 30 September 2010 at the Department of Obstetrics and Gynaecology, Rangpur Medical College Hospital, Rangpur, Bangladesh. 50 women presenting with PPH were included. Data were collected using a structured sheet covering demographics, antenatal care, history, delivery, management, and outcomes; analysed in SPSS 26 using frequencies and percentages. Results: The majority of women were aged 31-40 years (74%), with low education (52%) and annual income ≤50,000 BDT (64%). Most had irregular (51%) or no antenatal check-ups (32%), and 66% were multipara. Among out-of-hospital deliveries, 68.8% were attended by unskilled personnel. Normal vaginal delivery was most common (72%), and 56.3% of women arrived at the hospital 2-6 hours after PPH onset. Retained placenta was the leading cause of PPH in out-of-hospital deliveries (71.9%), while uterine atony predominated in hospital deliveries (77.8%). Management included manual removal of placenta (46%), injectable uterotonics (10%), uterotonic with misoprostol (8%), surgical repair of genital tract injuries (16%), and hysterectomy (4%). Clinical outcomes were favourable, with 98% of women improving, 2% mortality, and 78% discharged within 2-6 days. Conclusion: Maternal age, multiparity, education, inadequate antenatal care, unskilled birth attendance, and delayed referral contribute to PPH; timely structured tertiary management reduces maternal mortality in Bangladesh.