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Aim of the Work is To determine the significance of the placental thickness and the thickness of the uterine muscle layer at placenta attachment in the prediction of postpartum hemorrhage and to evaluate both of them as as parameters for identifying high-risk patients.
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PPH remains the most common cause of maternal mortality all over the world
PPH is a serious complication ) is a serious complication of labor and delivery with an incidence of approximately 5-10% and a mortality rate 0.5:1%
PPH can also be a cause of long-term severe morbidity and approximately 12% of women who survive PPH will have severe anaemia A significant percentage of deaths due to PPH can be due to a lack in assessing bleeding amount. Clinically assessing bleeding through inspection underestimates the actual bleeding volume and depending on haemodynamic abnormalities may be to late as effective countermeasures are often not taken in time so identifying pregnant women at risk of PPH prior to delivery is crucial to prevent PPH .
The leading cause of PPH is thought to be uterine atony - the failure of the uterus to contract fully after delivery of the placenta. PPH resulting from uterine atony is a major preventable cause of maternal morbidity and mortality, especially in developing countries .(B-Lynch et al., 2006)
Risk factors for PPH and its main causes, including weak uterine contractions, birth canal lacerations, placental factors, and coagulation abnormalities have been relatively well studied .
However the effect of placental attachment on the thickness of the myometrium and its correlation with PPH is not well studied . By exploring the potential correlation between thinner myometrium at the placenta and a higher incidence of PPH we can reduce mortality occuring with PPH. this study highlight the significance of evaluating the impact of placental attachment on myometrial thickness and placenta thickness in the context of PPH
The study will be carried out on 150 pregnant women, who will undergo delivery at benha university hospital either by vaginal delivery or cesarean section either as elective palnned at operative list or admitted to Obstetrics ER after complete clinical evaluation and decision taken by staff member of Benha gynecology and obstetrics department.
Informed consent will be obtained from all participants prior to commencing the study.
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Ahmed Abdelsalam Ahmed, resident
Data sourced from clinicaltrials.gov
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