Management and Outcomes of Antepartum Haemorrhage at Bombo Regional Referral Hospital

Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to significantly reduce the morbidity and mortality asso-ciated with this condition. Objectives: The study is aimed at determining the prevalence, etiology, sociodemographic characteristics, and the feto-maternal outcome of pregnancies complicated by APH. A total of 224 cases of APH were recorded out of the 18,273 cases admitted for delivery during the study period, giving an institutional prevalence rate of 1.2%. Two hundred and eighteen folders were retrieved and analyzed giving a retrieval rate of 97.3%. The mean gestational age at presentation was 35.3 ± 2 weeks and the most common causes were abruptio placenta and placenta previa constitut-ing 68.3% and 30.0%, respectively. Sociodemographic characteristics asso-ciated with the occurrence of APH included age, booking status, parity, and socioeconomic status. There were 123 live births and 92 stillbirths. The ce-sarean section rate was 53.5%. Major complications were intrauterine fetal deaths in 42.8%, postpartum hemorrhage in 24.2% of cases, and anemia ne-cessitating blood transfusion in 61.5%. There were three maternal deaths all due to abruptio placentae during the study period giving a case specific fatal-ity rate of 2%. The prevalence of APH in our setting is high. The major causes were abruptio placenta and placenta previa. The major fetal complication was intrauterine fetal death, and the major maternal complications were postpar-tum hemorrhage and anemia with consequent high blood transfusion rate. Early detection, provision of antenatal care, and emergency obstetric care services can reduce the negative effects of APH.