Factors of Primary Postpartum Hemorrhage among Women Delivered at Yirgalem General Hospital Southern, Ethiopia: A case control study
DOI:
https://doi.org/10.26911/thejmch.2021.06.06.12Abstract
Background: Primary postpartum hemorrhage continues to be the top leading cause of maternal mortality and morbidity all over the world, contributing about one third of all maternal mortality. Despite its public health importance of this problem, little is known about factors that contribute to primary postpartum hemorrhage especially in Ethiopia. The aim of this study was to assess the risk factors of primary postpartum hemorrhage.
Subjects and Method: Hospital based unmatched case control study design was used. The study was conducted in July 2019, among delivered women at Yirgalem general hospital from January 1, 2014 to December 30, 2018; to all cases of primary postpartum hemorrhage (n= 218) and 436 controls selected by using simple random sampling techniques. Women with primary postpartum hemorrhage were cases and women who had not diagnosed for primary postpartum hemorrhage were controls. Descriptive statistics and logistic regression analysis were made. Statistical association was measured by AOR and its 95% CI.
Results: Incidence of primary postpartum hemorrhage was 221 in 8,506 live births (2.6%) in the study period. Primiparas (AOR= 0.37 ;95% CI= 0.23 to 0.6; p= 0.001), grand multiparas (AOR= 5.80; 95% CI= 2.90 to 11.6; p <0.000) and rural maternal address (AOR= 1.90; 95% CI= 1.20 to 3.00; p= 0.008) were factors that have a statistically significant association with primary postpartum hemorrhage.
Conclusion: Parity and rural residence were associated factors. Therefore, the government and other responsible stakeholders should give attention to women with grand multiparas and those women residing in rural area. Immediate identification of risk factors and management might reduce largely the occurrence of primary PPH and related maternal deaths.
Keywords:
Primary postpartum hemorrhage, case-control, risk factors, EthiopiaReferences
Bibi S, Danish N, Fawad A, Jamil M (2007). An audit of primary postpartum hemorrhage. J Ayub Med Coll Abbottabad. 19(4): 1026
Carroli G, Cuesta C, Abalos E, Gulmezoglu AM (2008). Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol. 22(6): 999-1012. DOI: 10.1016/j.bpobgyn.2008.08.004.
Chohan A, Butt F, Mansoor H, Falak T (2006). Primary postpartum hemorrhage: outcome of different treatment measures. Biomedica. 22(1): 16-20.
Combs CA, Murphy EZ, Laros RK (1991). Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol. 77 (1):69-76. PMID: 1984230.
Cunningham, FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Sheffield JS (2014). Williams obstetrics (24th edition.). New York: McGraw-Hill Education: 1385.
Fikree FF (2002). Reproductive health in Pakistan: evidence and future directions of Reproductive Health. J Pak Med Assoc. 52(1): 34-41.
Gabbe GS, Jenniferr N, Joeleigh S, Markb L, Henryl G, Ericr MJ (2012). Obestetrics normal and problem pregnancies. sixth edition.
GLOWM (2007). The Global Library of Women's MedicinePostpartum Hemorrhage Fourth Edition of The Alarm International Program chapter 6th fourth edition, pp. 1-25.
de Vogel J, Heydanus R, Mulders AG, Smalbraak DJ, Papatsonis DN, Gerritse, BM (2011). Lifesaving intraosseous access in a patient with a massive obstetric hemorrhage. AJP reports. 1(2): 119 122. https://DOI.org/10.1055/s00311293514
Gϋlmezoglu AM, Forna F, Villar J, Hofmeyr GJ (2007). Prostaglandins for preventing postpartum hemorrhage. Cochrane Database of Systematic Reviews 3: CD000494.
Karine G, Mathilde R, Silvia L, Jonathan C, Adrien R, Evelyne C (2017). Incidence and risk factors of severe postpartum haemorrhage: A nationwide population-based study from a Hospital Database. Qual Prim Care. 25(2): 55-62.
Khan KS,Wojdyla D, Say L, Gulmezoglu AM, Van Look PF (2006).WHO analysis of causes of maternal death: a systematic review. Lancet. 367(9516): 1066-74. DOI: 10.1016/S01406736(06)683979.
Michael AB (2013). Overview of Postpartum Hemorrhage. In: Charles J Lockwood, Vanessa A Barss, editors. Uptodate, pp. 11- 48.
Mousa HA, Blum J, Abou El Senoun G, Shakur H, Alfirevic Z (2014). Treatment for primary postpartum haemorrhage. The Cochrane Database Syst Rev. 2014(2): 13 DOI: 10.1002/14651858.CD003249.pub3.
Olowokere AE, Adekeye O, Ogunfowokan A, Olagunju E, Irinoye O (2013). The prevalence, management and outcome of primary postpartum hemorrhage in selected health care facilities in Nigeria Int J Nurs Midwifery. 5(3): 28-34.
Nyfløt LT, Babill SP, Silje Pet/tersen,Iqbal Al-Zirqi, Margit Rosenberg (2017). Risk factors for severe postpartum hemorrhage. BMC Prenancy and Child birth 17(17):2-9. DOI: 10.1186/s1288401612170
Rath WH (2011). Postpartum hemorrhage-update on problems of definitions and diagnosis. Acta Obstet Gynecol Scand. 90(5): 421-8. DOI: 10.1111/j.16000412.2011.01107.x
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. (2014). Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2(6): e323-33. DOI: 10.1016/S2214109X(14)70227X.
Sheldon WR, Blum J, Vogel JP, Souza JP, Gulmezoglu AM, Winikoff B (2014). Postpartum haemorrhage management, risks and maternal outcomes. World Health Organization Multicountry Survey on Maternal and Newborn Health BJOG 1:5-13. DOI: 10.1111/14710528.12636.
Walraven G, Blum J, Dampha Y, Sowe M, Morison L, Winikoff B (2005). Misoprostol in the management of the third stage of labour in the home delivery setting in rural Gambia: a randomised controlled trial. BJOG 112(9): 1277-83 DOI: 10.1111/j.14710528.2005.00711.x
World Health Organizations (2010). Trends in maternal mortality in1990 to 2008. Estimates developed by: WHO, UNICEF, UNFPA and World Bank. Global causes and Trends in maternal mortality. Geneva.
World Health Organization (2011). WHO Recomendations for the prevention and treatment of PPH: Highlights and Key Messages from New 2012 Global Recommendations Maternal and Child Health Integrated Program Geneva. 35: 1-5.
World Health Organization (2012). Recommendations for the prevention and treatment of postpartum haemorrhage 2012 p.148. https://apps.who.int/iris/bitstream/handle/10665/75411/9789241548502_eng.
