Risk Factors and Postpartum Hemorrhage among Women with Vaginal Delivery

This study aims to find the correlation between risk factors and the incidence of postpartum hemorrhage (PPH) in normal vaginal deliveries.

The present research is an observational cohort study. Two hundred and thirty-nine women undergoing normal labor who delivered vaginally were given 0.2 mg of Ergometrine or 600 μg of Misoprostol at the delivery of the anterior shoulder, as a prophylaxis to prevent PPH. The blood loss was estimated by the use of blood collection drapes during delivery. All statistical analyses were conducted through SPSS version 27. The risk factors were compared between the groups with or without PPH.

The majority 87 (36.4%) of the participants were in the 25-29 years' age group, 113 were nullipara (47.3%), and 93 (38.9%) were primigravida. The prevalence of PPH was 4.6% (11/239). Almost half of the cases of PPH (5/11, 45.5%) had no risk factors, whereas those with risk factors had twin pregnancy (25%), low-lying placenta (50%), grand multipara (33.3%), and previous history of PPH (33.3%). Furthermore, a moderate positive correlation between the risk factors and the incidence of PPH was observed ( R = 0.512).

In this study, women with risk factors such as twin pregnancy, low-lying placenta, grand multipara, and previous history of PPH developed PPH despite prophylaxis and close monitoring. However, almost half of the cases of PPH occurred in people where there was no risk factor. It is recommended that vigilance for the early detection and appropriate preparation for the management of PPH should be followed even in low-risk women undergoing vaginal delivery.