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More than 8,000 women die and about 150,000 women suffer from postpartum hemorrhage complications every year in Pakistan, Primary postpartum hemorrhage, rightly called as obstetrician's nightmare, is defined as the loss of more than 500 ml of blood in the first 24 hours after childbirth.1 It is still one of the major causes of maternal mortality and morbidity all over the world2. In the developing country like ours the situation is even worse, where it accounts for 2131% of maternal mortality and morbidity.3 It's an obstetric catastrophe leading to hemorrhagic shock and even death.4 The management of postpartum hemorrhage is very much challenging as it is the most notorious for severe obstetric morbidity in terms of hysterectomy and maternal mortality. The main causes of PPH are uterine atony, which is the failure of uterus to contract and retract, trauma to the genital tract, retained placental tissue, coagulopathies, placenta previa and morbidly adherent placenta. The management of PPH involves both medical and surgical management. Medical management includes use of uterotonics like oxytocin and prostaglandin analogues e.g. prostaglandin E1, E2 and F2α. Surgical management involves conservative measures like uterine and internal iliac artery ligation, application of Brace sutures (B-lynch)5 and definitive and the most drastic measure i.e. hysterectomy with its short term and long-term sequelae.
Sardar Muhammad Alfareed Zafar. (2017) Primary Postpartum Hemorrhage- Still a Nightmare in Our Country, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-07, Issue-2.
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