A STUDY ON THE ASSOCIATION BETWEEN PRE-DELIVERY PLATELET AND COAGULATION PROFILES AND IMMEDIATE POST PARTUM HAEMORRHAGE IN A TERTIARY CARE HOSPITAL

Abstract

Background: Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality worldwide. Although pregnancy is associated with a physiological hypercoagulable state, abnormalities in platelet count and coagulation parameters may increase the risk of excessive bleeding. Aim and Objectives: To assess the association between pre-delivery platelet count and coagulation parameters with immediate postpartum haemorrhage in a tertiary care setting. Materials and Methods: This prospective observational study was conducted in the Department of Pathology at Medical College and Hospital over six months (January 2026–May 2026). A total of 113 pregnant women at ≥37 weeks gestation were included. Demographic and obstetric details were recorded. Pre-delivery blood samples were analyzed for platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT) and international normalized ratio (INR).Inferential statistics was performed with p < 0.05 statistically significant. Results: Out of 113 participants, 13 (11.5%) developed immediate PPH. Thrombocytopenia was significantly associated with PPH, with approximately 10-fold increased odds (OR = 10.73, p < 0.001). Mean APTT and TT were significantly higher among PPH cases (p = 0.042 and p = 0.013, respectively). PT and INR were elevated in PPH cases but did not show statistical significance. No significant association was observed between PPH and age, gravidity, or mode of delivery. Conclusion: Pre-delivery thrombocytopenia and elevated APTT and TT are significant predictors of immediate PPH. Routine assessment of these parameters may help identify high-risk women and improve maternal outcomes.