Frequency and Etiology of Primary Postpartum Hemorrhage in Pregnant Women Undergoing Vaginal Delivery
DOI:
https://doi.org/10.70749/ijbr.v3i5.2766Keywords:
Primary Postpartum Hemorrhage, Uterine Atony, Genital Tract Trauma, Vaginal Delivery, Maternal Morbidity.Abstract
Background: Primary postpartum hemorrhage continues to be among the most common causes of maternal mortality and morbidity worldwide, especially in resource-poor countries. Though vaginal delivery is safer compared to cesarean delivery in most respects, it is still associated with the threat of massive hemorrhagic complications. Objective: To determine the frequency and etiology of primary postpartum hemorrhage in pregnant women undergoing vaginal delivery at Hayatabad Medical Complex, Peshawar. Study Design: Cross-sectional descriptive study. Duration and Place of Study: The study was conducted from August 2024 to January 2025 at the Department of Obstetrics and Gynecology, Hayatabad Medical Complex, Peshawar. Methodology: A total of 233 women who underwent vaginal delivery were included. Women with coagulopathies, placenta previa/accreta, or cesarean deliveries were excluded. Blood loss estimation was done via gauze weighing. Etiologies such as uterine atony, genital tract tears, and retained placental tissue were clinically assessed under consultant supervision. Results: Primary PPH occurred in 19.7% of participants. Uterine atony was the leading cause (60.9%), followed by genital tract tears (34.8%) and retained placental tissue (4.3%). A significant association was found between socioeconomic status and PPH occurrence (p=0.016), with both poor and rich groups showing higher prevalence. Diabetes mellitus was significantly associated with specific PPH etiologies (p<0.001), particularly genital tract trauma and retained placenta. Conclusion: Primary postpartum hemorrhage remains a prevalent obstetric emergency in vaginal deliveries. Uterine atony is the predominant cause, with notable contributions from genital tract trauma.
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