Post partum haemorrhage in a teaching hospital in Nigeria: a 5-year experience

KO Ajenifuja, CA Adepiti, SO Ogunniyi

Abstract

Objectives: The aim was to determine the incidence, causes and the maternal mortality associated with postpartum haemorrhage in a tertiary centre in Nigeria.

Methods: Case records of all patients that had postpartum haemorrhage after vaginal delivery at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife unit over a 5-year period (January 1st, 2002 to December 31st, 2006) were reviewed and analysed. Post-partum blood loss was calculated by estimating blood loses in graduated containers and in bed
lines and gauze packs.

Results: 112 women had postpartum haemorrhage during the period under review. 76(67.86%) had primary postpartum haemorrhage and 36(32.14%) had secondary postpartum haemorrhage. The commonest cause of post partum haemorrhage was retained products of conception due mismanagement of the third stage of labour, this occurred in 88 women (78.57%) of cases. Other causes were uterine atony 12(10.71%), genital tract laceration 9(8.04%), disseminated intravascular coagulopathy
1(0.8%) puerperal sepsis 1(0.8%) and broken down episiotomy, 1(0.8%). The maternal mortality during the period was 90 out of which 6 were due to postpartum haemorrhage.

Conclusion: Retained products of conception resulting from  mismanagement of the third stage of labour is the most common cause of post partum haemorrhage in our centre.