Frequency of Postpartum Hemorrhage in Patients with Multiple Gestations

Abstract

Objective: To determine the frequency of postpartum hemorrhage (PPH) and its association with selected demographic and clinical characteristics among women with multiple gestations. Methods: This descriptive study was conducted at the Department of Obstetrics and Gynecology, MTI-Hayatabad Medical Complex, Peshawar, from November 01, 2023 to April 01, 2024. A total of 217 women with ultrasonography-confirmed multiple gestations were enrolled through non-probability consecutive sampling. PPH was defined as blood loss >500 mL after vaginal delivery or >1000 mL after cesarean delivery. Data on age, BMI, gestational diabetes mellitus, gestational hypertension, residence, educational status, social class, mode of delivery, and previous history of PPH were recorded. Data were analyzed using SPSS version 23.0. Associations were assessed using the chi-square test, and p<0.05 was considered statistically significant. Results: The mean age was 28.64 ± 6.72 years, and the mean gestational age was 35.48 ± 2.30 weeks. PPH occurred in 37 (17.1%) women. PPH was significantly associated with gestational diabetes mellitus (37/73; 50.7%, p<0.001), gestational hypertension (19/55; 34.5%, p<0.001), urban residence (37/109; 33.9%, p<0.001), and spontaneous vaginal delivery (37/73; 50.7%, p<0.001). All PPH cases were observed among illiterate women (37/73; 50.7%, p<0.001). No significant association was found with age group (p=0.297) or history of PPH (p=0.713). Conclusions: PPH was frequent among women with multiple gestations and showed significant associations with gestational diabetes, gestational hypertension, urban residence, illiteracy, and spontaneous vaginal delivery. Early identification of high-risk patients and standardized preventive strategies may reduce maternal morbidity.