Prevalence and maternal managemnt outcomes of primary postpartum hemorrhage among mothers deliverd at attat primary hospital snnpr state, guragie zone, south- Ethiopia, 2017.

Abstract

Background: Primary postpartum hemorrhage (PPH) defined as blood loss in excess of 500 ml and 1000ml from the genital tract within the first 24hours following vaginal delivery and cesarean delivery respectively. Postpartum hemorrhage is a main cause of considerable maternal morbidity and mortality worldwide. Seventy to ninety percent of immediate postpartum hemorrhage is attributed to uterine atony. Objective: To determine the prevalence, causes and management outcome of primary postpartum hemorrhage at Attat Primary Hospital, from January 1 to June 30/2017. Method: Hospital based cross-sectional study was done in Attat Primary Hospital: 105 diagnosed cases of primary PPH were subjected to a predesigned questionnaire. Data was collected using data collection checklists by patient interview and from patient folder by trained data collectors from January 1-June 30/2017. The collected data was cleaned, and entered and analyzed using SPSS Version 21 computer software. The results were presented by tables, diagrams, charts and text accordingly. Result: The prevalence of PPH was 5.9% with the commonest causes of uterine atony which represented 67.6% and followed by retained placenta and genital tract laceration which accounted 17.1% and 15.2% respectively. Anemia during pregnancy with AOR 6.84; 95% CI (1.40-15.51%), multiple pregnancy with AOR 6.41; 95% CI (3.92-10.46),pregnancy induced hypertension with AOR 18.58; 95% CI (1.02-33.72); and previous cesarean section with AOR 19.45; 95%CI (1.28-29.55) were associated risk factors for management outcome of primary PPH. Conclusion: The prevalence of primary postpartum hemorrhage was 5.9% and 3.8% of mothers were died during the study period. Anemia during pregnancy, multiple gestation, hypertensive disorder of pregnancy, and previous cesarean delivery were associated risk factors for maternal outcome. Recommendations: Risk factors associated for increasing maternal mortality from PPH like anemia during pregnancy, and hypertensive disorder of pregnancy should be identified and treated early during pregnancy; furthermore, well designed, large and multicentric studies are needed.