Primary Post-Partum Haemorrhage Following Vaginal Deliveries at the Douala General Hospital: Prevalence, Causes and Risk Factors
| Autor: | Fidelia Mbi Kobenge, Gregory Ekane Halle, Theophile Njamen Nana, Robert Tchounzou, Bongoe Adamo, Charlotte Tchente Nguefack, Javorez Thibaut Demgne, Fulbert Nkwele Mangala, Henri Essome, Thomas Obinchemti Egbe |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Referral business.industry Obstetrics Strategy and Management Mechanical Engineering Metals and Alloys Placental Retention Abortion medicine.disease Logistic regression Industrial and Manufacturing Engineering Confidence interval Uterine atony Medicine Tears business |
| Zdroj: | Open Journal of Obstetrics and Gynecology. 11:742-752 |
| ISSN: | 2160-8806 2160-8792 |
| Popis: | Background: Postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. It occurs predominantly in developing countries due to poorly developed infrastructures and lack of skilled birth attendants. Objective: To identify the prevalence, causes and risk factors of primary postpartum haemorrhage following vaginal deliveries in a referral hospital (Douala General Hospital-Cameroon). Methods: This was a descriptive and analytical study carried in the Douala General Hospital (DGH) for which socio-demographic, clinical, obstetric and post-partum data were collected using a pre-tested questionnaire. Descriptive statistics, multivariate analysis and logistic regression allowed us to present and discuss our results, with a 95% confidence interval (CI) and p value 0.05. Results: The prevalence of Primary Postpartum Haemorrhage was 1.33%. Quantification of bleeding was reported in only 13.15% of cases. The main causes were: uterine atony (36.18%), placental retention (25.65%), cervical tears (12.50%), perineal tears (10.52%) and cervico-vaginal tears (08.52%). The risk factors were: age between 19 - 35 years aOR = 4.52; 95% CI = 2.65 - 7.98; p = 0.021); unemployment (aOR = 4.74; 95% CI = 2.91 - 6.02; p = 0.001); being multigravida (aOR = 9.21; 95% CI = 6.43 - 12.48; p = 0.035); history of abortion (aOR = 5.11; 95% CI = 2.05 - 7.29; p = 0.004); preterm delivery (aOR = 6.88; 95% CI = 2.72 - 9.06; p = 0.002); duration of labour > 12 hours (aOR = 4.05; 95% CI = 2.46 - 7.98; p = 0.003) and macrosomia (aOR = 3.27; 95% CI = 1.03 - 5.68; p = 0.041). Conclusion: Primary postpartum haemorrhage remains a poorly assessed obstetric complication in the maternity ward of the Douala General Hospital (DGH); Training staff on quantifying postpartum blood loss and monitoring the second and third stages of labour can help to better manage and reduce its occurrence. |
| Databáze: | OpenAIRE |
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