Complicated Cases of Post-Partum Haemorrhage in the Tropics
  • 25/01/2017
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Complicated Cases of Post-Partum Haemorrhage in the Tropics

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Descripción de Complicated Cases of Post-Partum Haemorrhage in the Tropics

Post-partum hemorrhage is the leading cause of maternal mortality in Sub-Saharan Africa. Common causes include uterine atony, retained tissue, and lacerations, and can be severe especially if the patient presents late. In the tropics, such cases may be complicated by coagulopathy and thrombocytopenia. Contributing factors may be recurrent malaria, chronic anemia due to nutritional factors or hemoglobinopathies, and reactive hypersplenism (tropical splenomegaly). Treatment is complicated by limited blood products, late presentation due to poor infrastructure and transportation, and cultural factors. Even if PPH occurs in a health facility, these factors make treatment challenging. Despite surviving the initial hemorrhage, complications such as renal failure can lead to mortality 7-8 days postpartum in settings where limited laboratory and no dialysis exists. Several cases of complicated PPH are presented, highlighting the key factors that can lead to successful management— a team approach involving prompt medical treatment, ultrasound evaluation, transfusion, curettage, and surgical management.

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