Ginecologia e Obstetrícia Relato de caso Acesso livre

Abstrato

The demographic changes associated with primary postpartum hemorrhage in women delivered vaginally who were admitted to obstetric emergency in Al-Gumhory teaching hospital Sanaâ??a-Yemen

Sajedah Fadhl

Study sample and sampling: The study includes 100 women in obstetric emergency complaining of primary postpartum hemorrhage after vaginal delivery

Methods: In the study we had 100 women delivered vaginally admitted to obstetric emergency department in given period, with primary postpartum hemorrhage. The information was collected in a questionnaire from patients (Face-to-face) interview and from the files. The questionnaire was developed to cover the study objectives. A diagnosis of postpartum hemorrhage was given to patient with a visually estimated blood loss of < or = 500ml within the first 24 hours after vaginal delivery.

Analysis of Data: Data was analyzed by computer program SPSS V.23.

Results:

• There were (4,260) vaginal deliveries at the institution during the period from October 2018 to March 2020.there were (100) cases of primary postpartum hemorrhage during the study period. The incidence of primary postpartum hemorrhage was (2.3%).
• We found that the incidence of primary postpartum hemorrhage in age group 20-30y was (82%) most of them from urban by (71%), high incidence among low income society by (59%) most of women were with special habits as chewing qat by (59%).
• Most of women were multigravida by (58%) and (78%) were between (37-40) weeks of pregnancy.
• The incidence of women who did antenatal care (85%), of them (53%) (1-3 visit) and most of women follow antenatal care in governorate hospitals by (43%), only (2%) of women had multiple pregnancy, (3%) of patients with postpartum hemorrhage were polyhydrominous.
• (16%) pregnancies developed antepartum hemorrhage during their pregnancy.
• (74%) of pregnancies did not receive Mgso4.        
• (84%) delivered in hospitals, of them (56%) were delivered spontaneously, but (63%) of them duration of labor were<12h. 
• Factors associated with postpartum hemorrhage in women with each of these factors were anemia (47%), previous postpartum hemorrhage (41%), macrosomia (37%), and episiotomy (29%).
• Uterine atony was the most common cause of postpartum hemorrhage (57%), followed retained placenta (25%), birth canal tear (22%).

Conclusion: The incidence of primary postpartum hemorrhage in our study is (2.3%). The factors associated with postpartum hemorrhage found in our study were atonic uterus, retained placenta, anemia, genital tract trauma, prolonged labor, anemia, mostly in 20-35 years old, multipara, and low socioeconomic status patients. All findings in our study are near to findings in neighboring countries that had the same demographic changes