Incidence, Contributing Factors and Outcomes of Antepartum Hemorrhage in Jimma University Specialized Hospital, Southwest Ethiopia

Abstract

Background: Antepartum haemorrhage complicates three to five percent of pregnancies contributing to perinatal and maternal morbidity and mortality. Timely access to quality obstetric services is the major determinant of both maternal and newborn outcomes after antepartum haemorrhage. In Ethiopia, the magnitude and consequences of antepartum haemorrhage are not well studied. The objective of this study was to determine the incidence, factors associated with and maternal and perinatal outcomes of antepartum haemorrhage in Jimma University Specialized Hospital. Methods: A hospital-based prospective cohort study was conducted in Jimma University Specialized Hospital, from January 1 to December 31, 2013. Data were collected by reviewing medical records and interviewing mothers. Cumulative incidence of antepartum hemorrhage among mothers who gave birth and odds of adverse outcomes among mothers with and without antepartum hemorrhage were calculated. Odds ratio was calculated to estimate the effect of antepartum hemorrhage on maternal and new born adverse outcomes. Results: Between January and December 2013, 3854 women gave birth in JUSH. The incidence of antepartum hemorrhage was 5.1% (n=195) in 2013. The major causes of antepartum hemorrhage were abruptio placentae and placenta previa occurring in 127(65.1%) and 52(26.7%) of cases, respectively. Six (3.1%) of the patients with antepartum hemorrhage died. Of the 206 babies born, 63 (30.6%) were stillborn and additional 13 (6.3%) newborns died during the first seven days of life making perinatal mortality rate of 36.9%. Conclusion: Antepartum hemorrhage is a common complication of pregnancy and cause of maternal and perinatal mortality in Jimma University Specialized Hospital. The risk of adverse outcomes is very high compared to other countries. Efforts to improve access and quality of comprehensive emergency obstetric care services are required.

Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania

“…Women with placenta previa had also threefold higher odds of blood transfusion and fivefold odds of prolonged hospital stay. These findings are consistent with previous studies [ 7 , 9 , 15 ]. The increased risk of postpartum hemorrhage in women with placenta previa may be explained by the implantation of placenta in a previous scar which may go deep preventing placental separation.…”

“…Correspondingly, women with placenta previa had tenfold higher odds of Caesarean delivery [ 15 ]. This can be explained by the fact that the placenta in the lower segment obstructs engagement of the head especially for major previa.…”

Risk Factors of Antepartum Hemorrhage Among Mothers Who Gave Birth at Suhul General Hospital, 2016: A Case–Control Study

“…Incidence of placenta previa increases in a linear way with increasing number of previous cesarean sections. 2 , 6 , 12…”

“…Efforts to improve geographical access, referral services, and quality of comprehensive emergency obstetric care are needed to improve maternal and newborn outcomes in Ethiopia. 6 …”

“…Efforts to improve geographical access, referral services, and quality of comprehensive emergency obstetric care are needed to improve maternal and newborn outcomes in Ethiopia. 6 Vaginal bleeding after mid-pregnancy is associated with maternal and fetal risks. Maternal morbidity may be caused by acute hemorrhage and operative delivery, and the fetus may be compromised by uteroplacental insufficiency and premature birth.…”