Title: An Interesting Case of Secondary Post Partum Haemorrhage
Authors: Dr Sowmya Varudu, Dr Renuka Devi, Dr R. Jayanthi
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.61
Abstract
Introduction
Secondary postpartum haemorrhage (PPH) is defined as bleeding from or into the genital tract 24 hours after the birth of the baby within 6 weeks postpartum. It affects only 1-2 % of postnatal women. This low incidence of secondary PPH and its linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increasing morbidity and mortality.(1) Globally PPH remains the leading cause of maternal deaths. However in many low income countries (which accounts for highest burden) like India, there is still scarcity of information on magnitude of and risk factors for PPH. The jeopardy of PPH is rising with the secondary form of PPH, when women are already discharged home.PPH is widely underestimated obstetric problem with variable occurrence and severity when diagnosed. The most common aetiological factors are retained products of conception and sub involution of placental site/ endometritis(1)(6). A rare cause is partial or complete dehiscence of lower uterine segment incision(8), placental site trophoblastic tumour or choriocarcinoma.
References
- Hoveyda F, Mac Kenzie IZ. Secondary PPH incidence, morbidity and current management. BJOG 2001:108:927-30
- Alexander J, Thomas PW, Sanghera J. Treatments for secondary PPH (Review). Conchrane Database Syst Rev 2008;
- Sheldon WR, Blum J, Vogel JP, Souza JP, Gulmezoglu AM, Winikoff B. Postpartum haemorrhage management, risks and maternal outcomes: findings from WHO multicounty survey on maternal and new born health.BJOG.2014;121Suppl 1:5-13.
- Kittur S, Swetha D. Emergency peripartum hysterectomy-a study in tertiary care centreand medical college in Hubli, North Karnataka,India.Int J Reprod Contracep ObstetGynaecol.2016:5:1097-11013
- Shirodker SD, Pandey A,Yadav S. Emergency obstetric hysterectomy: review at a tertiary care hospital Int J Reprod Contracept Obstet Gynecol.2016,5:3811-4
- Babarinsa TA Hayman RG, Draycott TJ Secondary PPH challenges in evidence based causes and management. Eur J Obstet Gynecol Reprod Biol2011:159:255-60
- Medical News and Events. Fact sheet: Management of PPH.
- Nanda S, Singhal S, Sharma D,Sood M, Singhal SK. Nonunion of utcrine incision: a rare case of secondary PPH, report of two cases. Aust N ZJ Obest Gynaccol 1997:37:475-6.