Incidence of postpartum hemorrhage based on the use of uterotonics. Maternal outcomes in an intermediate complexity hospital in Bogotá, Colombia, 2016
DOI:
https://doi.org/10.18597/rcog.2916Keywords:
Pospartum hemorrhage, delivery, uterine ballon tamponade, treatment outcomeAbstract
Objective: To describe the incidence of postpartum obstetric haemorrhage (PPH), the interventions performed and the outcomes of these pregnancies in the first 24 hours.
Materials and methods: A series of cases of pregnant women who presented PPH after vaginal delivery or cesarean section between February 1 and October 31, 2016 in a public institution of médium complexity in Bogotá. Consecutive sampling. Sociodemographic, clinical and risk factors for PPH were measured. Outcomes measured were cause of PPH, degree of shock, estimated postpartum bleeding, frequency of activation of the “obstetric red code”, interventions performed, admission to an intensive care unit, blood transfusions and maternal mortality. Descriptive analysis was performed.
Results: Out of 1633 births (1080 deliveries and 553 cesareans), 35 cases (2.1 %) (26 and 9 cases respectively) were identified and the “obstetric red code” was activated in 11 cases (0.67 %). There was no maternal mortality. The main cause of PPH was uterine hypotonia in 29/35 (82 %) and 82.8 % of cases resolved with medical treatment. 4/35 (11.4 %) required uterine tamponade to control bleeding. 2/35 (5.6 %) of the women required surgical management: 1/35 (2.8 %) hemostatic sutures and 1/35 (2.8 %) hysterectomy.
Conclusions: The identification of severe PPH by more reproducible criteria for initiating timely treatment could be more effective and safer in terms of maternal outcomes.
Author Biographies
Luis Felipe López-García, Universidad Nacional de Colombia
Diana Paola Ruiz-Fernández, Universidad Nacional de Colombia
Carlos Germán Zambrano-Cerón, Universidad Nacional de Colombia
Jorge Andrés Rubio-Romero
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