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

  • Published
    11th Mar, 2022

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 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.”
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