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Table 4 Observation of Management of PPH in Hospitals

From: Quality of care in prevention, detection and management of postpartum hemorrhage in hospitals in Afghanistan: an observational assessment

 Causes of PPHTotal
Type of InterventionUterine atony n = 10 (%)Genital Tract tears
n = 12 (%)
Retained placentaa
n = 46 (%)
n = 68 (%)
Uterotonics (excluding AMSTL)9 (90%)6 (50%)34 (74%)49 (72%)
 Oxytocin7 (70%)2 (17%)25 (54%)34 (50%)
  Less than 40 IU3 (30%)1 (8%)17 (37%)21 (31%)
  40 IU or more4 (40%)1 (8%)4 (9%)9 (13%)
  not documented4 (9%)4 (6%)
 Misoprostol2 (20%)4 (33%)9 (20%)15 (22%)
  Less than 800 μg2 (17%)4 (9%)6 (9%)
  800 μg or more1 (10%)1 (8%)3 (7%)5 (7%)
  not documented1124
Uterine massage
 Yes10 (100%)10 (83%)40 (87%)60 (88%)
 No2 (17%)5 (11%)7 (10%)
 not documented11
IV fluids
 Yes9 (90%)10 (83%)42 (91%)61 (90%)
 No1 (10%)2 (17)4 (9%)7 (10%)
Blood transfusion
 Yes2 (20%)2 (17%)14 (30%)18 (26%)
 1 unit or less2 (20%)2 (17%)8 (17%)12 (18%)
 2 units or more3 (7%)3 (4%)
 unknown33
Additional Procedure
 Bimanual compression3 (30%)1 (8%)5 (11%)9 (13%)
 Aortic compression3 (30%)6 (13%)9 (13%)
 Genital tract tears repairN/A10 (83%)6 (13%)16 (24%)
 Removal of retained placenta/productsN/AN/A45 (98%)45 (66%)
 Tranexamic acid2 (20%)1 (8%)1 (2%)4 (6%)
 Hysterectomy1 (8%)1 (2%)2 (3%)
Recorded as PPH case in the logbook
 Yes9 (90%)7 (58%)30 (65%)46 (68%)
 No1 (10%)5 (42%)16 (35%)22 (32%)
  1. Note: all women’s outcome = alive
  2. aEleven women with retained placenta also had a perineal laceration