Asian Journal of Medicine and Health

Background: The early prediction of postpartum haemorrhage (PPH) in multifetal pregnancies using serum protein indicators is an important and understudied area of maternal health that is addressed in this research article. PPH continues to be a major global cause of maternal morbidity and mortality, especially in settings with limited resources. The goal of this study is to find affordable, non-invasive biomarkers for early diagnosis in order to improve maternal outcomes.

Objective: To study association of serum protein levels with post-partum hemorrhage in multifetal pregnancy.

Methodology: It was a Prospective observational study at Department of Obstetrics and Gynaecology, Pt. BD Sharma Post-Graduate Institute of Medical Sciences, Rohtak, Haryana, India, between December 2023 to December 2024. A total 100 cases with multifetal pregnancy with >30 weeks of gestation were included. A comprehensive case history was obtained, followed by a thorough general physical and obstetric examination. Routine investigations were conducted and the findings were documented. Quantification of blood loss was done immediately after the delivery of placenta. Blood loss of more than 1000mL was considered as PPH. An association between blood loss during delivery and serum protein levels was studied.

Results: Postpartum hemorrhage (PPH) occurred in 45% of multifetal pregnancies. The mean serum protein level was 6.27 g/dL in cases without PPH, while significantly lower levels were noted in PPH cases, averaging 3.82 g/dL (P = 0.008). Univariate logistic regression analysis revealed an adjusted odds ratio of 0.277 for serum protein levels, indicating that higher serum protein levels were associated with a 72.3% reduction in the likelihood of developing PPH (P = 0.007).

Conclusion: Multiple pregnancies complicated with hypoproteinemia need more attention to be paid for prevention and control of PPH during delivery. Hypoproteinemia must be corrected before delivery.