Introduction and Objective: Hemorrhage is the leading cause of maternal death in under-medicalized countries, with immediate postpartum hemorrhage (HPPI) accounting for over 25% of these cases. This study aims to reduce maternal deaths due to HPPI in our department. Patients and Methods: This case-control study was conducted in the Department of Gynecology and Obstetrics at the University Hospital Center (CHU) of Bouaké from January 1, 2018, to December 31, 2022. We matched cases of immediate postpartum hemorrhage (HPPI) with controls (normal deliveries). The study included 188 parturients, with 94 presenting with HPPI and 94 having normal deliveries. We identified risk factors, assessed severity, documented treatments, and evaluated maternal prognosis. Data analysis was performed using SPSS software, and proportions were compared using the chi-square test with a significance threshold of 5%. Results: The prevalence of HPPI was 0.53% of deliveries. The parturients were predominantly uneducated housewives and married in both groups, with statistically significant differences. Additionally, 51.06% of cases were referred from peripheral maternity units. The primary causes included uterine atony (53.19%), abnormal placental insertion (28.72%), and uterine rupture (10.64%). Active management of the third stage of labor (AMTSL) was implemented in 54% of cases. Uterine revision was performed in 54.25%, and severe anemia was present in 44.18%. Hemostatic hysterectomy and uterine repair (hysterorrhaphy) were conducted in 23.3% and 30% of cases, respectively. The case-fatality rate was 9.6%. Conclusion: HPPI remains a significant public health issue in our practice, characterized by a high case-fatality rate.
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