Primary post partum haemorhage(PPH) at the University of Maiduguri Teaching Hospital (UMTH): A ten –year review
Objective: To determine the incidence, risks and aetiological factors for Primary Post-Partum Haemorrhage (PPH) in UMTH.
Design Retrospective descriptive study.
Setting: University Of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
Methods: The case records of all recorded cases of primary PPH between1stJanuary 2000 and 31stDecember 2009 inclusive, who were managed in UMTH were retrieved and relevant data obtained and analyzed.
Results: Three hundred and seventy sixwomen had primary postpartum haemorrhage during the period under review with an incidence of 1.9%. However, only three hundred and two were available for analysis.Close to half of the women who had primary postpartum haemorrhage were grandmultiparous136(45%). Uterine atony was the commonest cause of primary PPH which was closely followed by retained placenta 37.7% and 22.5% respectively. This is attributed to mismanagement of labour. Majority of the patients were unbooked (63.6%) and about one third of
the women had home delivery. The maternal mortality during the period was 96out of which 4were due to postpartum haemorrhage. The contribution of primary PPH to maternal mortality was 4.2% during the study period.
Conclusion: Primary PPH is a largely preventable condition. Uterine atony and retained placenta were major causes of the condition in our center. This is a reflection of mismanagement of third stage of labour. Identification of patients at risk during pregnancy and labour with prompt intervention to prevent blood loss is advocated.
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