Factors Associated with Postpartum Hemorrhage Doring Caesarean Section That Phanom Crown Prince Hospital,That Phanom District, Nakhon Phanom Province

Abstract

Purpose :To determine factor(s) that associated with early postpartum hemorrhage in patient who undergone cesarean delivery in ThatPhanom Crown Prince Hospital.

Design:  Cross-sectional study

Materials and Methods: The data were retrospectively collected from medical records, registration book From the delivery room and the operating room. The population studied was pregnant women have been diagnosed early postpartum hemorrhage and  undergone cesarean delivery in ThatPhanom Crown Prince Hospital in the year 2017-2019.

Main findings: The pregnant women were 1,051  undergoing cesarean section at That Phanom Crown Prince Hospital. Based on data from 2017-2019 , factors  associated with  a postpartum hemorrhage after cesarean section with statistical significance were  age, number of births that were due ,Body mass index before cesarean section (BMI), height of fundus (HF) CM , gestational age (weeks), operative  time ,neonatal weight (kg) (p = <.001, <.001, <.001, <. 001, .002, <.042 and <.001) respectively, but the factors that do not related to early postpartum hemorrhage were hematocrit (%) and the number of antenatal care (times) (p = .244 and .291)

Conclusion and recommendations: For pregnant women who have those risk factors, we must strictly follow standard guideline in preventive measure and prompt to handle with postpartum hemorrhage following cesarean delivery. Besides manually intraoperative uterine massage to ensure uterine contractility, we suggest early consider changing dosage or type of uterotonic drugs ,closely monitor vital signs and carefully estimation of blood loss  within first 24 hours  to early recognition  of postpartum hemorrhage  and timely response.