Evaluation of clinical outcomes of primary postpartum haemorrhage cases referred to an Upazila health complex

Nafisa Jafreen; Sultana Afroj; Shahana Ferdousi; Shah M. M. Billah; Ummay S. Sharkar; M. Rafi Akter; Suraiya Siddika; Kamrun Nahar; Moumita Basak

doi:10.18203/2320-1770.ijrcog20252712

Authors

Nafisa Jafreen Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
Sultana Afroj Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
Shahana Ferdousi Department of Obstetrics and Gynaecology, Manikganj Medical College Hospital, Manikgonj, Bangladesh
Shah M. M. Billah Department of Radiology and Imaging, Sylhet Women's Medical College, Sylhet, Bangladesh
Ummay S. Sharkar Department of Radiology and Imaging, Sylhet Women's Medical College, Sylhet, Bangladesh
M. Rafi Akter Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
Suraiya Siddika Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
Kamrun Nahar Department of Obstetrics and Gynaecology, OGSB Hospital, Mirpur, Dhaka, Bangladesh
Moumita Basak Department of Obstetrics and Gynaecology, Nasirnagar Upazilla Health Complex, Brahmonbaria, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252712

Keywords:

Postpartum haemorrhage, Primary PPH, Maternal complications, Uterine atony, Rural healthcare, Bangladesh

Abstract

Background: Primary postpartum haemorrhage (PPH) is a leading cause of maternal mortality and morbidity, especially in low-resource settings. In Bangladesh, the burden of PPH is exacerbated by limited emergency obstetric care and delayed referral. Understanding the clinical profiles and outcomes of PPH at the primary care level is essential for improving maternal health. This study aimed to evaluate the clinical outcomes and associated risk factors of primary PPH cases referred to a rural Upazila Health Complex in Bangladesh.

Methods: A prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Nasirnagar Upazila Health Complex, Brahmanbaria, from July 2022 to June 2024. A total of 75 women with primary PPH were enrolled in this study. Data on sociodemographic characteristics, obstetric history, clinical presentation, and pregnancy-specific risk factors were collected using structured forms. Statistical analyses were performed using statistical package for the social sciences (SPSS) version 25.0, with a significance threshold of p≤0.05.

Results: Most participants were aged 21–30 years (48%) and resided in rural areas (86.7%). Uterine atony (78.6%), prolonged labour (60%), and induction of labour (52%) were predominant risk factors. The most common complications were maternal anaemia (84%), hypotension (80%), and birth asphyxia (36%). The clinical presentations were dominated by per-vaginal bleeding (92%) and abdominal pain (40%).

Conclusions: Primary PPH in rural settings leads to significant maternal and neonatal complications. Early identification, prompt referral, and improved emergency care infrastructure are important for reducing its impact.

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