Primary postpartum haemorrhage at the university of Port Harcourt teaching hospital: Prevalence and risk factors

Abstract

Background: Postpartum haemorrhage (PPH) is a leading global cause of severe maternal morbidity and mortality. Approximately 14 million women suffer postpartum haemorrhage annually and at least 128,000 of these women bleed to death. Most of these deaths, which occur within four hours of delivery and are as a result of problems during the third stage of labour. Majority of PPH related deaths occur in developing countries of the world where facilities are poorly developed in addition to a paucity of trained attendants at delivery. The objective of this study was to determine the prevalence, risk factors, causes and outcome of primary postpartum haemorrhage at the University of Port Harcourt Teaching Hospital (UPTH), south-South, Nigeria.

Method: This was a retrospective study of all consecutive births between January 1^st and December 31^st, 2014 at UPTH. The socio-demographic characteristics, mode of delivery, cause of primary postpartum haemorrhage, antenatal/ intrapartum risk factors, treatment received and outcome were extracted from the patients' case notes, entered into SPSS version 20.0 and analysed.

Results: Of the 8,694 women who were delivered at the maternity unit of UPTH, 178 had  primary postpartumhaemorrhage giving a prevalencerateof 4.28%. Uterine atony was the leading cause and delivery by Caesarean section was the leading risk factor. There were 5 mortalities from primary postpartum haemorrhage.

Conclusion: The prevalence of primary postpartum haemorrhage in UPTH is 4.28%. Uterine atony was the leading cause while Caesarean section was the commonest risk factor. Efforts should therefore, be made to reduce the caesarean section rate and improve surgical skills aimed at reducing blood loss at surgery.

Keywords: Post-PartumHaemorrhage; Maternal Morbidity Mortality; Uterine Atony; Caesarean Section