Haematocrit as diagnostic tool for assessing Primary Postpartum haemorrhage
Introduction: A woman is most vulnerable at the postpartum period. About 50-70% of maternal deaths occur in the postpartum period, of which 45% deaths occur in the first 24 hours after delivery and more than two thirds during the first week. Between 11-17% maternal deaths occur during child birth itself. There is a direct correlation between haemoglobin, haematocrit and red blood corpuscle values with the amount of blood loss. With increase in blood loss, the incidence of PPH will be more.
Materials and Methods: 500 pregnant women of 18-35 years, undergoing vaginal delivery at Mc Gann teaching district hospital, Shivamogga were evaluated for hematological parameters (Hb, Hct, RBC) during their admission for delivery and on first postpartum day. The American College of Obstetrics and Gynecology defines PPH as a 10% change in haematocrit value between the labour admission and postpartum period.
Results: There was reduction in the mean values of Hb, Hct, RBC and the results were statistically highly significant (p<0.001). The incidence of primary PPH was 14.8% as determined by 10% decrease in hematocrit level.
Conclusion: Laboratory analysis of haematological parameters, being simple and accurate method, has to be followed, even during postpartum period, to assess, to take necessary measures and to prevent primary PPH and thereby decreasing the maternal morbidity and mortality.
Keywords: Postpartum haemorrhage, Visual estimation, Hematocrit.