TITLE:
Management of Immediate Postpartum Hemorrhage at the University Hospital Center of the Sino-Central African Friendship
AUTHORS:
Roch M’betid-Degana, Gilles-Davy Kossa-Ko-Ouakoua, Geniva Gracelia Vanciane M’betid-Degana, Gamaliel Kerebi, Sandrine Sana-Ozako, Durant Poutou-Piri, Samuel Gondje, Appolinaire Hepatraud, Eugène Serdouma, Antoine Doui-Doumgba
KEYWORDS:
Haemorrhage, Postpartum Immediate, University Hospital Center of the Sino-Central African Friendship
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.11,
November
16,
2023
ABSTRACT: Introduction: Immediate postpartum hemorrhages constitute a frequent maternal complication
and remain at the forefront of maternal death in our countries. Objective: Contribute to improving the management of immediate postpartum hemorrhage in our
context with a view to reducing maternal mortality. Patients and Methods:
We conducted a retrospective descriptive and analytical study over a period of 12
months from January 1st to December 31st 2020. Results: We collected a total of 109 files on a total of 4360
deliveries. The frequency
of postpartum haemorrhages was of the order of 2.5%. The most represented age group
was between 20 and 24 years old. Pauciparas represented the majority of our study
population. 64.5% of patients were uneducated. These hemorrhages occurred in patients who often gave
birth outside the department with 63.8%. The main causes of postpartum hemorrhage
were cervical tears (51.2%) and partial placental retention (30.7%). The majority of these deliveries
(48.8%) were carried out by midwives followed by assistant midwives (33.2%). Active management of the
third period of delivery was systematic and immediate followed by the valve examination
completed by the infusion of oxytocin in case of uterine atony, tranexamic acid
ans misoprostol intrarectally. In the event of persistent hemorrhage, suture of
the cervical lesions, ligation of the cervical vessels or even laparotomy either
for the selective ligation of the blood vessels or for the hysterectomy for hemostasis
were practiced. We do not have a Nalador, nor a Bakry balloon, nor an Interventional
Radiology service for embolization of the uterine arteries. We deplore 1.3% of deaths
from afibrinogenemia. Conclusion: The frequency of immediate postpartum hemorrhages is
lower in our health facility. This is due to the rapid handling of cases. Improving
the quality of services offered to women during childbirth can further help reduce
the frequency of these hemorrhages.