Immediate post-partum haemorrhage: Epidemiological aspects and maternal prognosis at South N’djamena District Hospital (Chad)

Abstract

Background: Post-partum haemorrhage defined as blood loss after delivery over 500mls, affects all countries and is the commonest cause of maternal mortality. It is a frequent obstetric emergency in developing countries.

Objective: To identify the causes of post-partum haemorrhage and identify adequate management of immediate post-partum haemorrhage and thus reduce maternal mortality.

Patients and methods: This was a prospective and descriptive study of one year from 1st January 2014 to 31st December 2014 conducted at South N’Djamena district hospital. Before including a patient in our survey her consent was obtained after explaining to her the need for the survey. All consenting patients with post-partum haemorrhage were included. Data were analyzed using SPSS 17.0.

Results: We recorded 100 cases of post-partum haemorrhage among 6815 deliveries giving an incidence of 1.47%. The average age of the women was 25.0 years.The majority of deliveries (90%) were vaginal. The main cause of immediate post-partum haemorrhage was a third stage of labour bleeding (66%) followed by genital lesions (32%). The management was medical (uterotonic drug, fluid replacement and blood transfusion), obstetric (manual removal of placenta or clot), and surgical (suture of lesions, vascular ligature and hysterectomy). There were two maternal deaths (2%).

Conclusion: Post-partum haemorrhage is often fatal in our region. Preventive measures and efficient management can help to improve maternal prognosis.