To study implementation of PPH bundle approach for the management of postpartum haemorrhage at a tertiary care centre
Authors/Creators
- 1. International Journal of Medical Science and Innovative Research (IJMSIR)
Description
Abstract
Background & Methods: The aim of the study is to study implementation of PPH bundle approach for the management of Postpartum Haemorrhage. PPH bundle includes first and response to refractory PPH bundles. The First response bundle includes uterine massage, IV fluids, uterotonics and tranexamic acid13. In between the first and second bundle, there is a supportive and symptomatic approach which includes checking for tears and if present repairing tears and evacuation of the bladder and emptying the uterus if any tissues are present. Response to Refractory PPH bundle includes aortic and bimanual compression, intrauterine balloon tamponade and use of non-pneumatic anti shock garments supported by blood transfusions, surgical interventions and referral.
Results: Before the implementation of the PPH bundle approach, 183 patients (94.81%) who developed PPH were alive and discharged and 10(5.18%) died. After the implementation of the bundle approach,164(98.79%) patients were alive and discharged and patients died due to PPH reduced to 02(1.20%) (p = 0.037). The data indicates a significant improvement in patient outcomes and a significant reduction in maternal mortality following the implementation of the PPH bundle approach.
Conclusion: Postpartum Haemorrhage (PPH) bundle at our tertiary care centre have significantly improved the management and outcomes of PPH cases. This study, through a rigorous combination of prospective and retrospective analysis, has highlighted several critical areas of success. The consistent demographic profile and delivery modes suggest that the PPH bundle is broadly applicable and effective across diverse patient groups. Better stabilization of patients upon admission, as indicated by the improved shock index, underscores the effectiveness of the PPH bundle in managing PPH more efficiently. The increased use of tranexamic acid, intrauterine balloon tamponade, and non-pneumatic anti-shock garments, along with the reduced need for additional uterotonics and invasive procedures, demonstrates the efficacy of the PPH bundle approach in clinical practice.
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- https://ijmsir.com/issue/archive_issue/119/Issue%203%20May
References
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