Mode of delivery and fetomaternal outcomes in patients with postpartum haemorrhage: a retrospective study at a tertiary care centre in India

Background: Postpartum haemorrhage (PPH) remains an important cause of maternal mortality, particularly in low and middle-income countries including India. Although several obstetric risk factors contribute to PPH, the association between mode of delivery and fetomaternal outcomes remains an area of ongoing research. This study aimed to compare fetomaternal outcomes among women with PPH following vaginal, caesarean and instrumental deliveries and also to identify factors associated with severe maternal morbidity. Methods: A retrospective study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care hospital in India. Medical records of women diagnosed with PPH between January 2023 to January 2025 were reviewed. Data on demographic characteristics, obstetric variables, mode of delivery, causes of PPH, type of management, maternal complications and neonatal outcomes were collected and analysed. Results: Among 225 women with PPH, 110 (48.8%) had vaginal deliveries, 73 (32.4%) caesarean deliveries and 42 (18.6%) instrumental deliveries. Uterine atony was the commonest cause of PPH, particularly among vaginal deliveries. Blood transfusion was required in 29% of vaginal, 16% of caesarean and 9% of instrumental deliveries. ICU admission, obstetric hysterectomy, disseminated intravascular coagulation and prolonged hospital stay were more frequent following vaginal delivery. Low Apgar score, NICU admission and neonatal mortality were also more frequent among vaginal deliveries. Conclusions: Among women with PPH, vaginal mode of delivery was associated with higher maternal morbidity and adverse neonatal outcomes. Early recognition and prompt multidisciplinary management are essential to improve fetomaternal outcomes.