Background: Postpartum haemorrhage is one of the leading causes of maternal
morbidity and mortality worldwide. It occurs predominantly in developing
countries due to poorly developed infrastructures and lack of skilled birth
attendants.Objective:To identify the prevalence, causes and risk factors
of primary postpartum haemorrhage following vaginal deliveries in a referral
hospital (Douala General Hospital-Cameroon).Methods:This was a descriptive and analytical study carried
in the Douala General Hospital (DGH) for which socio-demographic, clinical,
obstetric and post-partum data were collected using a pre-tested questionnaire.
Descriptive statistics, multivariate analysis and logistic regression allowed
us to present and discuss our results, with a 95% confidence interval (CI) and p value <0.05.Results: The prevalence of Primary Postpartum Haemorrhage was 1.33%.
Quantification of bleeding was reported in only 13.15% of cases. The main
causes were: uterine atony (36.18%), placental retention (25.65%),
References
[1]
Organisation Mondiale de la Santé (2012) Recommandations de l’OMS pour la prévention et le traitement de l’hémorragie du post-partum. OMS, Genève.
[2]
Deneux, T.C., Bonnet, M.-P. and Tort, J. (2014) épidémiologie de l’hémorragie du post-partum. The Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 43, 936-950. https://doi.org/10.1016/j.jgyn.2014.09.023
[3]
Organisation Mondiale de la Santé (2015) Mortalité maternelle. OMS, Genève.
[4]
Kebede, B.A., Abdo, R.A., Anshebo, A.A. and Gebremariam, B.M. (2019) Prevalence and Predictors of Primary Postpartum Hemorrhage: An Implication for Designing Effective Intervention at Selected Hospitals, Southern Ethiopia. PLoS ONE, 14, e224579. https://doi.org/10.1371/journal.pone.0224579
[5]
Omonge, S., Mirembe, F., Wandabwa, J., et al. (2016) Incidence and Risk Factors for Postpartum Hemorrhage in Uganda. Reproductive Health, 13, 38.
https://doi.org/10.1186/s12978-016-0154-8
[6]
Fotso, M., René, N., Paul, R.-L., Martin, T., Roger, W., Aboubakar, G., et al. (1999) Enquête Démographique et de Santé (EDS), Cameroun 1998. Bureau Central des Recensements et des études de Population et Macro International Inc., Calverton.
[7]
Institut National de la Statistique (INS) et ORC Macro (2004) Enquête Démographique et de Santé du Cameroun (EDS) 2004. INS et ORC Macro, Calverton.
[8]
Institut National de la Statistique (INS) (2015) Enquête Démographique et de Santé et l’enquête par grappes à indicateurs multiples (EDS-MICS5) 2014, Rapport Final. Yaoundé, Institut National de la Statistique.
[9]
Schlesselman, J. (1974) Sample Size Requirements in Case-Control Studies of Disease. American Journal of Epidemiology, 99, 381-384.
https://doi.org/10.1093/oxfordjournals.aje.a121625
[10]
Magnann, E.F., Evans, S., Hutchinson, M., Collins, R., Howard, B.C. and Morrison, J.C. (2005) Postpartum Hemorrhage after Vaginal Birth: An Analysis of Risk Factors. Southern Medical Journal, 98, 419-422.
https://doi.org/10.1097/01.SMJ.0000152760.34443.86
[11]
Kinikanwo, I.G., John, D.O. and Mmom, C.F. (2015) Primary Postpartum Haemorrhage at the University of Port Harcourt Teaching Hospital: Prevalence and Risk Factors. Nigerian Health Journal, 15, 7 p.
[12]
Téguété, I., Sissoko, A., Djiré, M., Traoré, Y., Kayentao, K., Théra, T., et al. (2014) Hémorragies du post partum au Mali: fréquences, causes, facteurs de risque et pronostic. CNGOF. 38ème journées nationales. Paris.
[13]
Maiga, S.I. (2009) Hémorragie du post-partum immédiat au centre de sante de référence de la Commune I du district de Bamako. Thèse Doctorat, Université de Bamako, Bamako, 125 p.
[14]
Stafford, I., Dildy, G.A., Clark, S.L. and Belfort, M.A. (2008) Visually Estimated and Calculated Blood Loss in Vaginal and Cesarean Delivery. American Journal of Obstetrics and Gynecology, 199, 519.e1-7. https://doi.org/10.1016/j.ajog.2008.04.049.
[15]
Dalaba, M.A., Akweongo, P., Aborigo, R.A., Saronga, H.P., Williams, J., Aninanya, G.A., et al. (2015) Cost to Households in Treating Maternal Complications in Northern Ghana: A Cross Sectional Study. BMC Health Services Research, 15, 34.
https://doi.org/10.1186/s12913-014-0659-1
[16]
Tebeu, P.M., Halle, E.G., Itambi, M.D., Mbu, R.E., Mawamba, Y. and Fomulu, J.N. (2015) Maternal Mortality in Cameroon: A University Teaching Hospital Report. The Pan African Medical Journal, 21, 16.
[17]
Nem, T.D. (2004) Etude de la mortalité maternelle au centre de santé de référence de la commune V de Bamako de 1998 à 2002 à propos de 160 cas. Thèse Doctorat, Université de Bamako, Bamako, 27-77.
[18]
Thomas, T.A., Jared, O.O., Mathias, O. and Erneo, B.O. (2014) Risk Factors Associated with Post-Partum Hemorrhage at Juba Teaching Hospital, South Sudan, 2011. South Sudan Medical Journal, 7, 24.
[19]
Valdes, V., Adongo, P.B., Nwameme, A.U., Tabong, P.T.N. and Fernandes, M. (2018) Risk Factors for Self Reported Postpartum Hemorrhage in Ga East, Ghana. International Journal of Gynecology & Obstetrics, 142, 201-206.
https://doi.org/10.1002/ijgo.12523.
[20]
Sheldon, W.R., Blum, J., Vogel, J.P., Souza, J., Gülmezoglu, A.M. and Winikoff, B. (2014) Postpartum Hemorrhage Management, Risks, and Maternal Outcomes: Findings from the World Health Organization (WHO) Multicountry Survey on Maternal and Newborn Health. British Journal of Obstetrics and Gynaecology, 121, 5-13.
https://doi.org/10.1111/1471-0528.12636
[21]
Tsu, V.D. (1993) Postpartum Hemorrhage in Zimbabwe: A Risk Factor Analysis. British Journal of Obstetrics and Gynaecology, 100, 327.
https://doi.org/10.1111/j.1471-0528.1993.tb12974.x
[22]
Henri, M.D. (2013-2014) Facteurs de risque des hémorragies du post-partum à Yaoundé: Etude transversale analytique. Thèse Doctorat, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, 112.
[23]
Claudio, G., Fernando, A., José, M.B. and Pierre, B. (2009) Risk Factors for Postpartum Hemorrhage in Vaginal Deliveries in a Latin-American Population. Obstetrics & Gynecology, 113, 1313-1319.
[24]
Institut National de la Statistique (INS) (2015) Enquête Démographique et de Santé et l’enquête par grappes à indicateurs multiples (EDS-MICS5), 2014, Rapport Final. Institut National de la Statistique, Yaoundé.
[25]
Merger, R., Moure, J., Levy, J. and Melchior, J. (2001) Précis d’obstétrique. 6th Edition, Masson, Paris, 583.
[26]
Reyal, F., Deffarges, J., Luton, D., Blot, P., Oury, J.-F. and Sibony, O. (2002) Hémorragie grave du postpartum. The Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 31, 358-364.
[27]
Marocchini, M., Lauféron, J., Quantin, C. and Sagot, P. (2017) Postpartum Hemorrhage with Transfusion: Trends, near Misses, Risk Factors and Management at the Scale of a Perinatal Network. The Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 46, 455-460. https://doi.org/10.1016/j.jogoh.2017.03.011
[28]
Valery, S., Picone, O., Coatantiec, Y., Frati, A., Labrousse, C. and Ayoubi, J.-M. (2015) Prématurité modérée 34-37 SA: Description des causes et conséquences néonatales immédiates dans une maternité de niveau 2. Gynécologie Obstétrique & Fertilité, 43, 582-587. https://doi.org/10.1016/j.gyobfe.2015.06.009
[29]
Loaléneur, M. (2018) Impact de l’accouchement prématuré sur la survenue de l’hémorragie du postpartum immédiat. étude cas-témoins nichée au sein de la cohorte monocentrique brestoise HPP-IPF. Sciences du Vivant [q-bio].
[30]
Obossou, A., Salifou, K., Hounkpatin, B., Sidi, I., Hounkponou, A., Houngbo, O., et al. (2015) Risk Factors for Immediate Postpartum Hemorrhages in the Maternity of the University Teaching Hospital of Parakou. Gynecology and Obstetrics (Sunnyvale), 5, 7.
[31]
Tessier, V. and Pierre, F. (2004) Facteurs de risques au cours du travail et prévention clinique et pharmacologique de l’hémorragie du post-partum. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 8, 29-56.
https://doi.org/10.1016/S0368-2315(04)96646-X
[32]
Dupont, C., Rudigoz, R.C., Cortet, M., Touzet, S., Colin, C., Rabilloud, M., et al. (2014) Incidence, étiologies et facteurs de risque de l’hémorragie du post-partum: étude en population dans 106 maternités françaises. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 43, 244-253.
https://doi.org/10.1016/j.jgyn.2013.05.003