Abstract
Objective: To determine various presentation and management of primary post-partum hemorrhage (PPH) in patients at seen at our institution. Methodology: This Study was carried out at the Department of Obstetrics and Gynecology, Bolan Medical College Hospital, Quetta, Pakistan from January 2013 to January 2014. Patients with Post-partum hemorrhage with age ranging from 21 to 43 years were enrolled. Presentation and management were studied. Results: The study included 120 patients with mean age 32.43±6.23 years. Mean parity was 4.92±3.44. Uterine atony was the most common cause of primary PPH (n=64), following by tears of cervix, vagina and perineum (n=28), APH (n=17), uterine rupture (n=10) and eclampsia (n=1). All patients responds well to the medical or surgical treatment except seven (5.83) patient died. Conclusion: Primary PPH was an important cause of maternal mortality. Surgical management must be started timely after failure of first line treatment and be integrated in a global strategy aimed to control hemorrhage. PPH can be prevented by avoiding unnecessary inductions/augmentations of labor, identification of high risk patients and use of active 3rd stage management protocol.

Sumaira Humza, Shazia Saeed, Hazrat Ali, GM Parkani, Zaman Kasi. (2017) Various presentations and management of primary postpartum hemorrhage at BMCH, Quetta, Pakistan, , Volume-42, Issue-1.
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