Primary Postpartum Haemorrhage [PPH] In Ilorin: Current Trends.

Abstract

Postpartum Haemorrhage [PPH] remains a major cause of maternal mortality all over the world. In line with the attainment of the Millennium Development Goal [MDG-5] which aims to reduce maternal death by three quarters, there is the need for a regular review. This study was carried out to determine the incidence of Primary Postpartum Haemorrhage following vaginal delivery and evaluate the trend at the University of Ilorin Teaching Hospital [UITH], Ilorin, Nigeria. This study was a hospital based retrospective study of all cases of Primary Postpartum Haemorrhage [PPH] following vaginal delivery at the centre between 1stJanuary 2004 and 31stDecember 2008. The case notes of all women who had primary PPH over the study period were retrieved from the records department of the hospital and necessary information was extracted. The results were compared with previous studies on primary PPH at the centre from 1987-2003. There were 14,700 vaginal deliveries, primary PPH occurred in 614 giving the incidence of PPH as 4.2%. Unbooked patients had a three times higher risk of developing primary PPH than their booked counterparts; the commonest risk factor was grandmultiparity [27.0%], uterine atony was the commonest aetiology [54.1%] and 64.8% had blood transfusion. Uterine massage and uterotonics were effective in 44.3% and two maternal mortalities were recorded during the period. The trend in primary PPH over a 22 year period showed an improvement in survival and a reduction in mortality. Primary PPH can occur in any woman in labour, thus all parturient must be managed by skilled attendants who can promptly diagnose and manage the problem. Antenatal blood donation for pregnant women will improve availability of blood and blood products for treatment of primary PPH; evaluation of the primary PPH scourge is an important index in evaluating the impact of the Millennium Development Goal-5.

Keywords: Primary Postpartum Haemorrhage, Trend, Ilorin, Vaginal delivery.