A study of risk factors of postpartum hemorrhage and indications for caesarean section

Bhavana G., Abhishek MV, Suneeta Mittal


Background: To prevent post-partum hemorrhage the concept of active management of third stage of labour has been proposed which decreases the blood loss by 40-68%. The best preventive strategy is active management of the third stage of labour. The objective of the study was to study risk factors of postpartum hemorrhage and indications for caesarean section.

Methods: A hospital based cross sectional study was carried out among 100 women at term for a period of one year. Pregnant women who are at term i.e. at 38-39 weeks of gestation were included in the study. Detailed history, clinical examination and investigations were carried out.

Results: The mean pre pregnancy BMI in study group was 22.4±3.96. The majority of patients recruited were primiparous. Socio-demographic data shows that there was no statistical difference in place of residence, occupation and level of literacy between two groups. The prevalence of anemia among women at term was found to be 43%. The most common obstetric high risk factor was gestational diabetes mellitus in 10% followed by gestational hypertension in (6%). 71% of women underwent the emergency LSCS. The most common indication for LSCS was fetal distress in 29% of cases followed by mal-presentation in 12% of cases.

Conclusions: The prevalence of anemia among women at term was found to be 43%. The different medical high risk factors were human immunodeficiency virus positive (asymptomatic diagnosed during pregnancy), Hepatitis B antigen positive, cardiovascular risk, hypothyroidism, epilepsy observed in the groups. Other high risk factors included asthma, Crohns disease, and systemic sclerosis.


Postpartum hemorrhage, Caesarean section, Term pregnancy

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