DOI: https://doi.org/10.36347/sasjm.2025.v11i02.004

Pages: 109-116

Background: The concurrent presentation of dengue fever and postpartum hemorrhage poses unique clinical challenges, yet systematic research examining their combined management remains limited. This study analyzes prevention strategies, diagnostic approaches, and treatment outcomes in 100 cases of dengue fever complicated by postpartum hemorrhage. Methods: A prospective observational study was conducted at Department of Medicine, Mugda Medical College and Hospital, Dhaka, Bangladesh from January 2023 to December 2023. We enrolled 100 consecutive cases of laboratory-confirmed dengue infection in postpartum women who developed primary postpartum hemorrhage. Patients were monitored for clinical manifestations, laboratory parameters, transfusion requirements, and maternal outcomes. Standardized protocols for prevention, diagnosis, and treatment were implemented and evaluated. Results: Among the study population (mean age 27.3±4.8 years), 45% presented with dengue without warning signs, 38% with warning signs, and 17% developed severe dengue. The median blood loss was 750mL (IQR: 600-950mL) for vaginal deliveries and 1200mL (IQR: 1000-1450mL) for cesarean sections. Platelet counts reached their nadir (mean 45,000±18,000/μL) on day 3 postpartum. Transfusion requirements increased significantly with dengue severity, with severe cases requiring a mean of 4.8±1.6 units of PRBCs. The maternal mortality rate was 2%, with all deaths occurring in the severe dengue category. Multivariate analysis identified platelet count <50,000/μL (OR: 3.8, 95% CI: 2.1-6.9) and blood loss >1500mL (OR: 4.2, 95% CI: 2.3-7.6) as significant predictors of adverse outcomes. Conclusions: The convergence of dengue infection and postpartum hemorrhage significantly impacts maternal outcomes, requiring modified management protocols and intensive monitoring. Early recognition of risk factors, particularly severe thrombocytopenia and excessive blood loss, is crucial for optimizing outcomes. Our findings ...