Risk factors & Maternal Morbidity & Mortality of massive primary Postpartum Haemorrhage in Omdurman Maternity Hospital

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Hassan, Sahar
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University of Khartoum
Postpartum haemohrrage is an important cause of maternal morbidity and mortality. In this study the incidence, risk factors, medical intervention, and short term maternal morbidity and mortality were studied. This is a prospective, descriptive study carried out in Omdurman maternity hospital in the period of 1st of December 2003 to thirty 1st of March 2004. Information was collected from the patients who developed postpartum haemorrage (PPH) in the first 24 hours after delivery and needed blood transfusion in Omdurman maternity hospital using structural coded questionnaire. Sixty-seven women were studied; those who developed PPH and did not need blood transfusion were excluded. Most of the study population was in the age group between 30 and 39 years (47.76%) and more than half were from urban areas (77.61%). The patients distributed almost equally in relation to parity (32.84%- 34.32%). There was frequent association between PPH and anaemia (37.37%), antipartum haemorrhage (28.36%), pre-eclampsia (29.85%), multiple pregnancy (13.43%), and previous PPH (14.93%). There was no significant association between PPH and prolonged first stage of labour or augmentation of labour (P=0.199), (P=0.979) respectively. Concerning the mode of delivery 47.76% was spontaneous vaginal delivery, 11.94% was instrumental delivery and 33.33% was caesarian section. Active management of the third stage of labour was done to 21(31.34%) of the study population and the remaining 46(68.65%) were managed conservatively. IV 8 The study found that uterine hypotonia is the major aetiological cause of PPH (65.67%), followed by genital tract trauma (23.88%) and retained placenta (10.45%). Clinical intervention included both medical and surgical treatments. Oxytocin was the main drug used in the patients (95.52%). Ergometrine was used in 80.60% of the cases. The surgical treatment ranged between repair under general anesthesia (14.93%) and cesarean hysterectomy (13.43%). Regarding the short term maternal morbidity and mortality, 2 patients (2.99%) developed acute renal failure, 8(11.94%) patients developed DIC, 2 patients needed admission to the intensive care unit, and the maternal mortality was 3 (4.47%).
96 Pages
Omdurman Maternity Hospital;Postpartum Haemorrhage;blood;United state of America;World health organization