Geetika Thakur1, Aruna Kumar2, Deepti Gupta3
BACKGROUND
The third stage of labour starts when the fetus has completely delivered and ends
with the complete expulsion of the placenta. The third stage of labour is usually
uneventful, although significant complications can occur in this period, the most
common is postpartum haemorrhage (PPH). The purpose of this study was to
identify the various third stage complications, their incidence, and associated risk
factors in patients admitted to the centre.
METHODS
This is a prospective observational study performed in the Department of
Obstetrics and Gynaecology, Gandhi Medical College and Sultania Zanana Hospital
(SZH), Bhopal conducted from 1st October 2010 to 30th September 2011. All
patients who delivered in our centre or outside and developed a third stage
complication were included in the study.
RESULTS
There were a total of 10,277 deliveries during the study period and 171 cases of
third stage complications. The incidence of third stage complication was 1.66 %.
The most common third stage complication was traumatic PPH (52.1 %) and the
least common was inversion of uterus (2 %) but the case fatality rate (20 %) was
higher in the latter. The incidence of traumatic PPH was highest among the
primipara patients (72.9 %) and in the grand multipara, atonic PPH topped the list
occurring in 57.8 % of the patients.
CONCLUSIONS
As third stage complications occur in approximately 1 in 60 deliveries and cause
19.3 % of the total maternal deaths, it is of utmost importance to outline an
effective treatment for the management of postpartum haemorrhage. This could
further help in reducing maternal mortality significantly.
