Abstract
Background: Postpartum maternal morbidity is becoming a major public health concern worldwide due to impact of modern development in feto-maternal medicine and maternal care. Major acute and long term maternal morbidities which may occur during obstetric management affect the life and reproductive career of women. Objective: To assess the trends, risk factors and pattern of postpartum maternal morbidity in Ikot Ekpene a local community in southern Nigeria. Materials and Methods: This was a 4-year prospective cross sectional observational study carried out in the maternity section of General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria between 2008 and 2011. Parturients managed in the hospital for postpartum morbidity were recruited for the study. Relevant information was obtained from structured questionnaire administered to the patients and those extracted from other medical records in the course of managing the patients. This was analysed using the SPSS computer statistical package. Result: A total of 5760 women delivered during the period, of which 296 (5.1%) were treated for postpartum morbidity. Most of the patients (46.9%) were between 31 and 40 years old and 68.8% were of low educational background. Half of the deliveries with morbidity were conducted by unskilled attendants. The most common maternal morbidity encountered included primary postpartum haemorrhage (22.2%), genital sepsis (16.1%), and hypertensive disorders (12.8%). Anaemia (12.8%) and malaria (11.1%) were the commonest non obstetrics causes of morbidity. It was relatively more common with delivery attended by untrained personnel. There was significant reduction in morbidity in the last 2 years of this study. Conclusion: The incidence of postpartum morbidity in the Ikot Ekpene is still high with a downward trend over the years. Obstetric haemorrhage, hypertensive disorders, anaemia and genital tract sepsis were the common causes and were commoner with delivery attended by unskilled personnel. It is hoped that supervision of deliveries by skilled medical attendants, improvement in general health and educational level will reduce postpartum morbidity in this rural community.
Highlights
The post partum period is very important but most neglected during obstetric care [1]
A total of 5750 deliveries were conducted in the hospital during the 4 years period and 296 patients were managed for postpartum morbidity giving incidence of 5.1%
There was a gradual reduction over the period but the non obstetric causes are becoming more prevalent
Summary
The post partum period is very important but most neglected during obstetric care [1]. The mother condition is considered when complications are noticed This may result in avoidable morbidity [3]. Even though The World Health Organisation defines the postpartum period or purperium as beginning after the delivery of the placenta and continuing until 6 weeks (42 days) after the birth of infant, maternal morbidity generally refers to complications that arise during pregnancy, delivery or the postpartum period [1,4,5,6]. Many of the postpartum complications that lead to maternal morbidity and mortality arise during labour, delivery and in the first 1 - 2 weeks following delivery [6,7,8]. Anaemia (12.8%) and malaria (11.1%) were the commonest non obstetrics causes of morbidity It was relatively more common with delivery attended by untrained personnel.
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