Analysis of 348 consecutive cases of primary postpartum haemorrhage at a tertiary hospital in Nigeria

Ijaiya, MA; Aboyeji, AP; Abubakar, Danladi

doi:10.1080/0144361031000119529

Cited by 34 publications

(32 citation statements)

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“…However the average blood loss, drop in haemoglobin concentration levels in both study groups were not statistically significant. This is similar to previous studies (12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Discussionsupporting

confidence: 81%

MISOP ROSTOL : AN ALTERNATIVE TO OXYTOCIN IN MANAGEMENT OF 3 rd STAGE OF LABOUR IN RURAL INDIA??

yadav¹,

gaur²,

meena³

2017

Int J Recent Sci Res

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ARTICLE INFO ABSTRACTBackground: Postpartum haemorrhage is a life-threatening obstetricemergency that occurs after normal vaginal delivery or caesarean section. Prevention of PPH can be achieved by active management of the third stage of labour in most of the cases. Various uterotonic agents play major role in prevention of PPH. Objective: To compare efficacy of oxytocin 10 IU intramuscular and misoprostol 800µg per rectally in active management of the third stage of labor and determine duration of the third stage of labor, blood loss, effect on haemoglobin of the patient, adverse effects and need for additional uterotonics in both group. Study methods: A prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Kanwatiya Hospital, SMS Medical College, Jaipur(Rajasthan) from December 2016 to February 2017. Active management of 3rd stage of labor was done by using either inj. Oxytocin 10 IU or tab. Misoprostol 800µg as per the group of the patient. Duration of the third stage of labor,the amount of blood loss, the incidenceof postpartum haemorrhage, a drop in haemoglobinconcentration from predelivery to 24 h after delivery and adverse effect of drugs were measured. Results: Demographic characteristics were similar in each treatmentgroup. There was no significant difference between treatment groups in decrease in hemoglobin (oxytocin 0.7 g/dL, misoprostol 0.8 g/dL). Duration of 3 rd stage of labor was slight more with misoprostol group.The significant side effect was shivering and fever, which were more common in the misoprostol group (shiveringmisoprostol 14% vs. oxytocin 5% and (fever -misoprostol 6% vs. oxytocin 1%). Conclusion: Rectal misoprostol 800µg is as effective as 10 IU intramuscular oxytocin in minimizing blood loss in the third stage of labour. Rectal misoprostol has a lower incidence of side effects which are self limiting. This supports the utility of misoprostol as a safe and effective uterotonic for use in the rural and remote areas of developing countries where other pharmacologic agents may be less feasible.

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Section: Discussionsupporting

confidence: 81%

MISOP ROSTOL : AN ALTERNATIVE TO OXYTOCIN IN MANAGEMENT OF 3 rd STAGE OF LABOUR IN RURAL INDIA??

yadav¹,

gaur²,

meena³

2017

Int J Recent Sci Res

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“…The incidence of PPH in a low-resource tertiary hospital in Nigeria was found to be 4.5%,6 in Uganda, (an African country) it was 9%,7 and it was 6.4% in the high-resource country of the Netherlands in Europe 8…”

Section: Introductionmentioning

confidence: 96%

Postpartum hemorrhage: incidence, risk factors, and outcomes in a low-resource setting

Ngwenya¹

2016

IJWH

112

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BackgroundPrimary postpartum hemorrhage (PPH) is defined as blood loss from the genital tract of 500 mL or more following a normal vaginal delivery (NVD) or 1,000 mL or more following a cesarean section within 24 hours of birth. PPH contributes significantly to maternal morbidity and mortality worldwide. Women can rapidly hemorrhage and die soon after giving birth. It can be a devastating outcome to many young families. Women giving birth in low-resource settings are at a higher risk of death than their counterparts in resource-rich environments. PPH is a leading cause of maternal deaths globally, contributing to a quarter of the deaths annually.AimsThis study aims 1) to document the incidence, risk factors, and causes of PPH in a low-resource setting and 2) to document the maternal outcomes of PPH in low-resource setting.MethodsThis was a retrospective descriptive cohort study carried out at Mpilo Central Hospital, a tertiary referral government hospital in a low-resource setting in Bulawayo, Zimbabwe. Data were obtained from the labor ward birth registers for patients who had a diagnosis of PPH during the period from January 1, 2016 to June 30, 2016. The case notes were retrieved and the demographic, clinical, and outcome data were gathered. Blood loss was estimated postdelivery by the attending clinician – either a midwife or a doctor. At this maternity unit, blood loss is not measured but estimated owing to prevailing resource constraints. The SPSS Version 21 statistical tool was used to calculate the mean and standard deviation (SD) values. Simple statistical tests were used on absolute numbers to calculate percentages.ResultsThere were 4,567 deliveries at the institution during the period from January 1, 2016 to June 30, 2016. There were 74 cases of PPH during the study period. The incidence of primary PPH was 1.6%. The mean age was 27.7 years (SD ±6.9), mean gestational age was 38.6 weeks gestation (SD ±2.2), and mean birth weight was 3.16 kg (SD ±0.65) for the studied group of patients. Three-quarters (75.7%) of the cases had NVD. The majority of the cases (77.0%) had an identifiable risk factor for developing primary PPH. The most identifiable risk factor for primary PPH was pregnancy-induced hypertension followed by prolonged labor. Uterine atony was the most common cause of postpartum hemorrhage (82.4%). The women who delivered by NVD, who were diagnosed with a PPH, and who lost an estimated 500–1,000 mL of blood were 73.2%; 25% lost 1,000–1,500 mL of blood, and 1.8% lost more than 1,500 mL of blood. The women who delivered by lower-segment cesarean section, who were diagnosed with a PPH, and who lost an estimated 1,000–1,500 mL of blood were 77.8%, and 22.2% bled an estimated 1,500 mL of blood or more. The majority of the cases of primary PPH (94.6%) survived the condition and 5.4% died.ConclusionThe incidence of PPH at Mpilo Central Hospital was 1.6% during the study period, lower than that reported elsewhere in similar setting in the literature. This study, therefore, is important as it documents fo...

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“…Primary postpartum haemorrhage (PPH) is generally defined as blood loss of more than 500 mL within first 24 h postpartum [1]. The reported prevalence varies widely from 4.5% to 19% [2–3]. It is associated with significant maternal morbidity and mortality [4].…”

Section: Introductionmentioning

confidence: 99%

Is primary postpartum haemorrhage a good predictor of inherited bleeding disorders?

Kadir¹,

Kingman²,

Chi³

et al. 2007

Haemophilia

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A study was conducted to evaluate the value of screening for inherited bleeding disorders in women with primary postpartum haemorrhage (PPH). Over a 2-year period, women identified to have PPH (defined as >500 mL blood loss for spontaneous vaginal delivery, >700 mL for instrumental deliveries and >1000 mL for caesarean sections within 24 h of delivery) were invited to participate in this study testing for a possible underlying bleeding disorder at 3-9 months post-delivery. Women known to have an inherited bleeding disorder were excluded. Of the 5744 deliveries in our unit during the study period, 152 (3%) fulfilled the criteria for primary PPH and 50 women agreed to participate in the study. Of these, 25 (50%) had a spontaneous vaginal delivery, 8 (16%) had an instrumental delivery and 17 (34%) had a caesarean section. Half of the women were multiparous and five (20%) had PPH in their previous pregnancy. Nineteen (38%) and 12 (24%) reported at least one significant personal and family bleeding history, respectively. One (2%) woman was identified to have von Willebrand disease. In conclusion, primary PPH does not appear to be a strong predictor of inherited bleeding disorders. Further studies are required to assess the prevalence of inherited bleeding disorders among these women.

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Analysis of 348 consecutive cases of primary postpartum haemorrhage at a tertiary hospital in Nigeria

Cited by 34 publications

References 10 publications

MISOP ROSTOL : AN ALTERNATIVE TO OXYTOCIN IN MANAGEMENT OF 3 rd STAGE OF LABOUR IN RURAL INDIA??

MISOP ROSTOL : AN ALTERNATIVE TO OXYTOCIN IN MANAGEMENT OF 3 rd STAGE OF LABOUR IN RURAL INDIA??

Postpartum hemorrhage: incidence, risk factors, and outcomes in a low-resource setting

Is primary postpartum haemorrhage a good predictor of inherited bleeding disorders?

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