Document Type : Original Article
Authors
1
Assistant Professor, Department of Obstetrics and Gynecology, Ovulation Dysfunction Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3
General Practitioner, Department of Obstetrics and Gynecology, Ovulation Dysfunction Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4
Associate Professor, Department of Obstetrics and Gynecology, Ovulation Dysfunction Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Introduction: Postpartum hemorrhage is one of the maternal mortality and morbidity etiologies. Recognizing predisposing factors, forecasting the risk of hemorrhage, preparing for that and using perfect medical and surgical interventions on appropriate time can decrease in mortality and morbidity of pregnant women. This study was done aimed to investigate the causes of hemorrhage and treatments of postpartum hemorrhage.
Methods: This descriptive analytical and retrospective study was conducted on all women who have had delivery in two governmental hospitals of Mashhad, Iran, 2010-2011. Women who needed to transfusion or reservation of two units of packed cells were included in this study.
The predisposing factor, delivery method, therapeutic methods of controlling hemorrhage and maternal complications were evaluated. Data were analyzed using SPSS software version 14. P value less than 0.05 was considered significant.
Results: 21181 deliveries have performed during 2010-2011 and only 248 cases (11.8%) needed to transfusion or reservation of packed cells. Cause of hemorrhage were atony in 138 cases (55.6%), residue in 66 cases (26.6%), genital rupture in 42 cases (16.9%) and myoma in 2 cases (0.08%). Pregnancy termination techniques were cesarean in 66 cases (48%) and normal vaginal delivery in 71 cases (52%).
Medical interventions that used to control hemorrhage were administration of oxytocin, methergine, misoprostol, bimanual massage and revision, and only one patient needed ten medical and surgical procedures to control hemorrhage. No case of maternal death was observed due to hemorrhage.
Conclusion: There are various medical and surgical procedures to control postpartum hemorrhage, and if the intervention was done correctly and timely, the need for invasive procedures, complications and mortality is reduced.
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