PRIMARY POSTPARTUM HAEMORRHAGE IN FEDERAL MEDICAL CENTRE, OWERRI, NIGERIA: A SIX YEAR REVIEW.

BACKGROUND

Primary postpartum hemorrhage is an obstetric emergency and is a leading cause of maternal morbidity and mortality in developing countries. It a condition that requires vigilance, prompt and appropriate management.

OBJECTIVE

To determine the prevalence and determinants of primary post partum haemorrhage in Federal Medical Centre Owerri.

METHODS

All cases of all cases of primary post partum haemorrhage managed at FMC Owerri. The case notes were retrieved from the hospital's Records Department and information on socio-demographic characteristics, nature of labour (spontaneous, induced or augmented) duration of labour and mode of delivery and birth weight, estimated blood loss and the need for blood transfusion were obtained.

RESULTS

Out of a total of 4889 deliveries, 3725 (76.2%) women had vaginal delivery while 1,164 (23.8%) women had caesarean section. Out of these deliveries, 166 women had Primary Post Partum Hemorrhage (PPH), giving a prevalence of 3.4%. Multiparous women had higher prevalence compared to nulliparas: 88 (48.3%) versus 37 (22.2%) respectively. The commonest cause of primary PPH was uterine atony 72 (43.4%) and cervical laceration was the least cause constituting 13 (7.7%). Caesarean section was associated with higher prevalence of post partum haemorrhage, 94 (56.4%). Duration of second and third stages of labour lasting more than 30 minutes and 10 minutes respective were associated with higher risk of primary PPH:82 (49.5%) and 87 (52.3) respectively.

CONCLUSION

Supervised antenatal care, active management of labour and emergency obstetric care, if employed religiously will drastically reduce post partum haemorrhage and thus its associated complications.