Abstract
Background: Antepartum haemorrhage complicates three to five percent of pregnancies contributing to perinatal and maternal morbidity and mortality. Timely access to quality obstetric services is the major determinant of both maternal and newborn outcomes after antepartum haemorrhage. In Ethiopia, the magnitude and consequences of antepartum haemorrhage are not well studied. The objective of this study was to determine the incidence, factors associated with and maternal and perinatal outcomes of antepartum haemorrhage in Jimma University Specialized Hospital. Methods: A hospital-based prospective cohort study was conducted in Jimma University Specialized Hospital, from January 1 to December 31, 2013. Data were collected by reviewing medical records and interviewing mothers. Cumulative incidence of antepartum hemorrhage among mothers who gave birth and odds of adverse outcomes among mothers with and without antepartum hemorrhage were calculated. Odds ratio was calculated to estimate the effect of antepartum hemorrhage on maternal and new born adverse outcomes. Results: Between January and December 2013, 3854 women gave birth in JUSH. The incidence of antepartum hemorrhage was 5.1% (n=195) in 2013. The major causes of antepartum hemorrhage were abruptio placentae and placenta previa occurring in 127(65.1%) and 52(26.7%) of cases, respectively. Six (3.1%) of the patients with antepartum hemorrhage died. Of the 206 babies born, 63 (30.6%) were stillborn and additional 13 (6.3%) newborns died during the first seven days of life making perinatal mortality rate of 36.9%. Conclusion: Antepartum hemorrhage is a common complication of pregnancy and cause of maternal and perinatal mortality in Jimma University Specialized Hospital. The risk of adverse outcomes is very high compared to other countries. Efforts to improve access and quality of comprehensive emergency obstetric care services are required.
Highlights
Adverse pregnancy outcomes including maternal and perinatal morbidity and mortality constitute major public health problems in the developing world
Abruptio placentae and placenta previa are the major causes of Antepartum hemorrhage (APH) [16, 17]
Study Setting: The study was conducted from January 1, 2013 to December 31, 2013 in Jimma University Specialized Hospital (JUSH), a teaching hospital located in Jimma town of Oromia Regional State, Ethiopia
Summary
Adverse pregnancy outcomes including maternal and perinatal morbidity and mortality constitute major public health problems in the developing world. Obstetric haemorrhage remains one of the major causes of maternal deaths [7,8,9,10], and one of the primary obstetric causes of perinatal mortality [11,12,13]. Antepartum haemorrhage complicates three to five percent of pregnancies contributing to perinatal and maternal morbidity and mortality. Access to quality obstetric services is the major determinant of both maternal and newborn outcomes after antepartum haemorrhage. The objective of this study was to determine the incidence, factors associated with and maternal and perinatal outcomes of antepartum haemorrhage in Jimma University Specialized Hospital. Conclusion: Antepartum hemorrhage is a common complication of pregnancy and cause of maternal and perinatal mortality in Jimma University Specialized Hospital. Efforts to improve access and quality of comprehensive emergency obstetric care services are required
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