Antepartum hemorrhage at a tertiary care teaching hospital in Nepal

Authors

  • Sarada Duwal Shrestha Patan Academy of Health Sciences, Lalitpur, Nepal
  • Reena Shrestha Patan Academy of Health Sciences, Lalitpur, Nepal
  • Alka Singh Patan Academy of Health Sciences, Lalitpur, Nepal
  • Praban Sharma Patan Academy of Health Sciences, Lalitpur, Nepal
  • Anagha Malla Pradhan Patan Academy of Health Sciences, Lalitpur, Nepal
  • Sushma Lama Patan Academy of Health Sciences, Lalitpur, Nepal

DOI:

https://doi.org/10.3126/jpahs.v4i2.24585

Keywords:

antepartum hemorrhage, placenta previa, perinatal mortality Nepal

Abstract

Introductions: Antepartum hemorrhage (APH) is a serious obstetrical emergency and is a leading cause of maternal and perinatal morbidity and mortality. Incidence varies from 2-5% of all deliveries. The maternal and perinatal complications of APH are anemia, postpartum hemorrhage, shock, low birth weight, intrauterine fetal death and birth asphyxia.

Methods: This descriptive study was conducted at Department of Obstetrics and Gynaecology of Patan Hospital, a tertiary care teaching hospital of Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. All patients who were admitted after 22 weeks of gestation with diagnosis of antepartum hemorrhage from April 2012 to April 2016 were included.

Results: The incidence of APH was 0.23% in the present study. Out of 84 patients, 39.3% were in age group of 25-29 years, 63% were multigravidae, 63% had placenta previa, 92.3% lower segment caesarean section done in new onset APH and 53.1% done in previous admitted cases of APH, 23.8% developed hypovolemic shock, 14.3% needed blood transfusion, 9.5% had postpartum hemorrhage, 1.2% had caesarean hysterectomy, 54.8% had preterm delivery, 9.5% were admitted in neonatal intensive care unit and perinatal mortality was 10.7%.

Conclusions: APH is a major cause of maternal and perinatal morbidity and mortality. In our study, the most common cause of APH was placenta previa. The commonest mode of delivery was caesarean section. The major maternal complication was hypovolemic shock with consequent high blood transfusion rate and fetal complication in prematurity.  

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Author Biographies

Sarada Duwal Shrestha, Patan Academy of Health Sciences, Lalitpur, Nepal

Assistant Professor, Department of Obstetrics and Gynaecology

Alka Singh, Patan Academy of Health Sciences, Lalitpur, Nepal

Associate Professor, Department of Obstetrics and Gynaecology

Praban Sharma, Patan Academy of Health Sciences, Lalitpur, Nepal

Professor, Department of Obstetrics and Gynaecology

Anagha Malla Pradhan, Patan Academy of Health Sciences, Lalitpur, Nepal

Lecturer, Department of Obstetrics and Gynaecology

Sushma Lama, Patan Academy of Health Sciences, Lalitpur, Nepal

Lecturer, Department of Obstetrics and Gynaecology

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Published

2017-11-15

How to Cite

Shrestha, S. D., Shrestha, R., Singh, A., Sharma, P., Pradhan, A. M., & Lama, S. (2017). Antepartum hemorrhage at a tertiary care teaching hospital in Nepal. Journal of Patan Academy of Health Sciences, 4(2), 44–48. https://doi.org/10.3126/jpahs.v4i2.24585

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Section

General Section: Original Articles