Burden and Risk Factors of Postpartum Haemorrhage among Normal Delivery Cases at A Tertiary Care Hospital

Open Access

Abstract

Background: Postpartum haemorrhage (PPH) remains a significant cause of maternal mortality and morbidity globally, accounting for approximately 27% of all maternal deaths. This study aimed to determine the prevalence of PPH and its determinants among women who had delivered by normal vaginal delivery in a Bangladeshi tertiary care hospital. Methods & Materials: This is a cross-sectional study, conducted in Sylhet MAG Osmani Medical College Hospital from January, 2024 to December, 2024 among 200 women who had delivered by normal vaginal delivery. Data were collected by direct observation and medical record review using a standardized checklist. PPH was defined as blood loss > 500 mL in 24 hours after delivery. Data were compared using SPSS version 26, chi-square test, and binary logistic regression to identify independent predictors with adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results: The incidence of PPH in normal deliveries was 14.0% (n=28). Independent predictors of PPH included advanced maternal age ≥30 years (AOR=2.27, 95% CI: 1.08-4.76), multiparity (AOR=2.09, 95% CI: 1.03-4.25), fewer than four antenatal visits (AOR=2.61, 95% CI: 1.25-5.45), prolonged labor ≥12 hours (AOR=2.80, 95% CI: 1.32-5.94), and perineal tear (AOR=3.35, 95% CI: 1.31-8.56). In the group with PPH, 42.9% had mild haemorrhage, 35.7% had moderate haemorrhage, and 21.4% had severe haemorrhage. Blood transfusion was required in 64.3% of PPH cases, with one maternal death recorded (3.6%). Conclusion: PPH was prevalent and was associated with multiparity, maternal age, poor antenatal care, prolonged delivery, and perineal tear. Identification of risks early, management of the third stage of delivery actively, and providing antenatal care universally is important to decrease mortality and morbidity among mothers.