Immediate Postpartum Haemorrhage at the Libreville University Hospital Centre: Epidemiological Profile of Women

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Abstract Introduction In Gabon, the frequency of maternal deaths directly related to Immediate PostPartum Haemorrhage (IPPH) is 15 to 25%, despite the different means that World Health Organization (WHO) has made available to the providers of the Emergency Obstetrical and Neonatal Care (EmONC). The objective of this study was to determine the prevalence and epidemiological characteristics of IPPH in order to improve its management and reduce the rate of maternal deaths.Methods An analytical retrospective study involved 42,728 records, whose data were collected using a chart collection form on the basis of information contained in partograms and other patient records. The description of the sample is made using numbers and proportions. The relationship between the etiologies of IPPH and certain characteristics of the women was established using the ORs with their 95% confidence interval. The difference was significant if p < 0.05.Results The prevalence of IPPH was 1.6%. The 20-39 age group was the most represented. Multiparous women accounted for 67.2%. Delivery hemorrhages accounted for 65.5% of IPPH. The main factors associated with delivery hemorrhages were multiparity (p<0.001), preterm and postterm (p<0.001), and child weight >4,000 g (p<0.001). Those associated with genital track injuries were young maternal age, multiparity (p<0.001).ConclusionsThe prevalence of IPPH was 1.6%. The most common etiology was hemorrhage from delivery. Multiparity remains the most common risk factor and the young age of the patients. It is important to improve management through better assessment of blood loss in the immediate postpartum as well as capacity building of health providers on EmONC.

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