Aim- To study the outcome of implementing Postpartum Haemorrhage Emergency

care using a bundle approach (PPH EmC) in the management of patients with PPH in

a tertiary referral center in North India.

Materials and methods- The study was conducted in a tertiary referral hospital in the

department of Obstetrics and Gynaecology of Sir Sunderlal hospital, Banaras Hindu

University, Uttar Pradesh state, India for a period of 12months from June 2021 to June

2022. It is a prospective observational study. Prior to the study, training of health care

providers including medical and paramedical staff was done using World Health

Organization guidelines on Postpartum Hemorrhage Emergency Care (PPH EmC)

using bundle approach. The data was collected by chart review and the outcome was

observed in percentages.

Results- the prevalence of PPH was 4.25%. PPH was the cause of maternal mortality

in 8.7% cases. Atonic PPH was most common (76%). A significant correlation was

found between amount of blood loss and requirement of refractory interventions (p=

0.004) and 3.7% of the patients died due to intractable PPH. Of the patients died with

PPH, 75% patients died due to delay in referral from other facilities. There is significant

increase in mortality in referred patients (p=0.03). There is no significant decrease in

mortality rate after the implementation of PPH bundle (p=0.125).

 

Conclusions- Mortality due to PPH reduced after the implementation of PPH care

bundles. Mortality rates were higher in referred patients due to delayed referral of

patients.