RISK FACTORS, CHALLENGES AND MANAGEMENT OF POST PARTUM HAEMORRHAGE IN NDUTH, OKOLOBIRI, NIGERIA: A 5- YEAR EXPERIENCE

*Ekine Atombosoba A, Ikeanyi E, Abasi Isreal, Ibrahim Isa A

ABSTRACT

Objective: We aimed at exploring and comparing the incidence, risk factors, causes, treatment modalities and the outcome regarding the patients with PPH in a new tertiary centre in south-south Nigeria. Methods: Data from hospital records were used between January 1 st.2009 to December 31 st. 2013. For of all patients that had postpartum haemorrhage after vaginal delivery and cesarean section at Niger Delta University Teaching Hospital, Okolobiri, were reviewed and analyzed using Epi info version 7.1.4.0. Post-partum blood loss was calculated by estimating blood loses in graduated containers and in bed lines and gauze packs. Results: A total of 174 women had postpartum haemorrhage during the period under review. 152(86.64%) had primary postpartum haemorrhage, while 22(12.54%) had secondary postpartum haemorrhage. The commonest cause of post partum haemorrhage was retained products of conception due to lack of expertise and mismanagement of the third stage of labour, 61(35.06%) of cases. The other major causes were uterine atony 51(29.31%), genital tract laceration 12(6.90%), abruption placenta 17(9.69%), placenta previa 10(5.75%), uterine rupture 10(5.75%) disseminated intravascular coagulopathy 2(1.15%) sub-involution of uterus and puerperal sepsis 4(2.29%) and wrong repair of episiotomy and wound broken down, 7(4.02%). A total of 12(6.90%) maternal mortality was recorded during the period. Conclusively: Though retained products of conception is the most common cause of post partum haemorrhage in this review, it is also obvious that patient’s poor compliance to modern health care services and strong belief in the traditional health care system had immensely contributed to the negative outcome.

Keywords: Postpartum Haemorrhage, TBA, Unbooked, Risk-Factors, Mortality, NDUTH.