Determinants and management out come of post partum hemorrhage among mothers delivered in attat primary hospital, guragie zone, southern Ethiopia, 2019

Abstract

Postpartum haemorrhage refers loss of more than 500 and/or 1000 ml of blood within 24 hour following vaginal, caesarean delivery respectively. It is significant public health problem both in developed and developing countries, causing considerable maternal mortality and morbidity. In Ethiopia, the government launches different strategies to prevent postpartum haemorrhage. But still more than half of the maternal mortalities occurred after delivery due to haemorrhage. Even though postpartum haemorrhage is one of the major direct causes of maternal death in Ethiopia, there are only few studies done in the country. Therefore, determining risk factors that predispose womens to postpartum haemorrhage is important to make different interventions. Objective: To assess determinant factors and management outcome of Postpartum Hemorrhage among mothers delivered at Attat primary Hospital, Gurage Zone, Southern Ethiopia,from january 2016 up to december2018. Method: Hospital based case control study design was used to include 200 mothers who gave birth during the study period. Data was collected using data collection checklists from logbook and patient folder by trained data collectors after they were trained for three days. The collected data was cleaned and entered and analyzed using SPSS Version 22 computer software. Bivariate and multivariable analysis was used to identify an independent predictors of PPH. The results are presented by tables, graphs, charts and text as appropriate. Result: All the 200 cards were found to be complete and used for data retrieval resulting in 100% completeness rate. The mean age of the respondents was 31.4 years. The finding of this study showed that mothers with prolonged labor, whose labor was induced or augmented, with retained placenta and mothers with previous history of c/s, were about 3 times (AOR=2.8[1.2, 14.5]), 2 times (AOR=1.8[1.2, 4.8], 23 times (AOR=23[3.2, 28.5] and 15 times (AOR=15[2.5, 38] more likely to develop PPH when compared with their counterparts respectively. Finally, mothers with hypertensive disorders of pregnancy and those with macrosomia were about 18 and 6 times more likely to develop PPH when compared to their counterparts (AOR=17.6[1.8,34.2] and 5.8[2.3,9.2]) respectively. Conclusion: Based on the finding of this study, most of Management Outcome of the mothers encountered with post-partum hemorrhage was good 43 (86%). It was found that having history of retained placenta, mothers whose labour was prolonged, Induced /augmented labour, mothers with previous history of c/s, mothers with hypertensive disorders and mothers who had macrosomia were found to be an important determinants or risk factors for postpartum hemorrhage in the study population. Recommendations: Emphasis should be given on prevention and early detection of risks factors for PPH, in order to reduce the burden of postpartum hemorrhage.