TITLE:
Primary Post-Partum Haemorrhage Following Vaginal Deliveries at the Douala General Hospital: Prevalence, Causes and Risk Factors
AUTHORS:
Théophile Njamen Nana, Robert Tchounzou, Fulbert Nkwele Mangala, Henri Essome, Javorez Thibaut Demgne, Fidelia Mbi Kobenge, Bongoe Adamo, Thomas Obinchemti Egbe, Charlotte Tchente Nguefack, Gregory Ekane Halle
KEYWORDS:
Primary Postpartum Haemorrhage, Prevalence, Causes, Risk Factors
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.6,
June
18,
2021
ABSTRACT: 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.