Publication:

Duration of labour and severity of postpartum haemorrhage: a case-control study

Background Postpartum haemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, contributing significantly to adverse maternal outcomes. Hence, this study aimed to compare the duration of labour in women with and without PPH and among women having PPH with and without risk factors. Also to determine the gradient effect of duration of labour on severe PPH and maternal consequences of PPH.

Methods A case-control study was conducted in the department of obstetrics, Fernandez hospital, Hyderabad. The required sample size was 197 cases and 397 controls (1:2 ratio) within 8 months duration.

Results The mean age of the cases and controls were 28±3.66 and 28±3.91 years, respectively. Anaemia was more prevalent among cases (10.15%) than controls (4.03%), with a p=0.001. Hypertension was more common in controls (16.1%) than in cases (9.1%), with a p=0.02. The mode of conception differed significantly, with assisted conception being more prevalent among cases (7.6%) compared to controls (3.8%) (p=0.04). The duration of various labour stages was significantly longer in cases than in controls. Intrapartum fever was significantly higher in cases (37.06%) compared to controls (15.37%), (p≤0.001).

Conclusions The study results indicate that longer durations of labour, the need for oxytocin augmentation, and specific maternal characteristics such as anaemia and mode of conception are significant predictors of PPH. The gradient effect of labour duration on the risk of PPH suggests that monitoring labour progression and timely intervention are crucial in preventing severe haemorrhage.