Postpartum haemorrhage remains leading cause of maternal deaths in Kerala: Report

Context

As per a new report, Postpartum haemorrhage (PPH) has been a leading cause of maternal deaths in Kerala for the better part of the last decade.

About

About Postpartum Haemorrhage (PPH):

According to WHO, Postpartum Haemorrhage (PPH) is commonly defined as a blood loss of 500 ml or more within 24 hours after birth.
Severe PPH is defined as a blood loss of 1,000 ml or more within the same timeframe.
Postpartum haemorrhage (PPH) is a complication of delivery and the most common cause of maternal death, accounting for about 35% of all maternal deaths worldwide.
PPH is the leading cause of maternal mortality in low-income countries and the primary cause of nearly one quarter of all maternal deaths globally.
Thus 99% of all maternal deaths occur in developing countries with more than half of these deaths occur in sub-Saharan Africa and almost one third occur in South Asia.

What causes postpartum haemorrhage?

Once a baby is delivered, the uterus normally contracts and pushes out the placenta.
After the placenta is delivered, these contractions help put pressure on the bleeding vessels in the area where the placenta was attached.
If the uterus does not contract strongly enough, these blood vessels bleed freely and as a result the proper constriction of the vessels does not happen and they keep bleeding profusely.
This is the most common cause of PPH. If small pieces of the placenta stay attached, bleeding is also likely.
Postpartum haemorrhage may also be caused by:
Tear in the cervix or tissues of the vagina
Tear in a blood vessel in the uterus
Hematoma formation
Inversion of uterus
Blood clotting disorder
Placenta problems

Findings from the report:

Maternal mortality ratio has come down significantly in the state to 28 in 2019-2020, from 38.4 in 2010-2011.
PPH deaths were highest in the 20-29 age groups. This is also the age group that has the highest number of deliveries.
At 46 per cent, atonic PPH — “failure of the uterus to contract following delivery” leading to excessive bleeding is the most common type of obstetric haemorrhage.
Moreover, a third of PPH deaths were recorded in caesarean births, highlighting “the importance of practicing safe caesarean section technique and postoperative monitoring.”