Immediate Post-Partum Haemorrhage: Epidemiological Aspects and Maternal Prognosis at N?Djamena Mother and Child Hospital (Chad)

Abstract

Introduction: The post-partum haemorrhage affects women in all countries and is the main cause of maternal mortality. It remains a frequent obstetric emergency in developing countries. Objective: Identify the main causes of post-partum haemorrhage aiming to propose adequate management in order to reduce the mortality due to the post-partum haemorrhage. Patients and Methods: This was a prospective and descriptive survey of nine months from April, 14th 2013 to January, 14th 2014 conducted at N’Djamena Mother and Child hospital. All patients that had presented the post - partum haemorrhage after delivery at N’Djamena Mother and Child hospital were included. Before including a patient in our survey her consent was obtained after explaining to her the need for the survey. All consenting patients with post-partum haemorrhage were included. Data were analyzed using SPSS17.0. Results: We recorded 69 cases of post-partum haemorrhage among 5456 deliveries giving a frequency of 1.26%. The average age was 24.98 years. The majority of deliveries were vaginal (89.9%). The main cause of immediate post-partum haemorrhage was a third stage bleeding (76.8%) followed by genital lesions (23.2%). The management was medical (fluid replacement solution and blood transfusion), obstetrical (manual removal of placenta, uterine revision), and surgery (suture of lesions, ligature of uterine artery and hysterectomy). We had registered one maternal death (1, 4%) among enrolled patients. Conclusion: Post-partum haemorrhage is a fatal obstetric emergency in our region. Preventive measures and curative means can help to improve maternal prognosis.