Author(s)

William Ako Takang^1,2, Fouelifack Ymele Florent^1,2, Egbe Thomas Obichemti^1,2, Obande Valery Fukara^1,2

¹Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon.
²Department of Obstetrics and Gynecology, Bamenda Regional Hospital, North West Region, Bamenda, Cameroon.

Background: Approximately 830 women die from pregnancy-related conditions daily with 99% of these maternal deaths occurring in low resource countries. Primary postpartum haemorrhage (PPH) accounts for 25.7% of maternal deaths in Africa. In Cameroon, postpartum hemorrhage remains the leading cause of maternal death, with little information on the primigravidae population compared to multigravida or multiparity. Objective: The aim of this study was to assess the factors associated with postpartum haemorrhage amongst primigravidae women giving birth in two hospitals within the Bamenda Health District. Methods: This study was a multicentric, non-randomized cross-sectional descriptive and analytic study. Of the 221 women interviewed regarding their willingness to participate in the study, 197 consented. Quantification of blood loss was done by visual estimate and with the assistance of the pathfinder international wall chart for visual estimation of blood loss. Data was collected using a structured questionnaire and analyzed using SPSS version 23. A P-value of <0.05 used to determine association between variables was considered statistically significant. Results: The prevalence of postpartum hemorrhage in primigravidae was 7.1%. The risk factors of postpartum hemorrhage were: induction of labour (P-value < 0.01), duration of labour (P-value < 0.01), augmentation (P-value < 0.05), mode of delivery (P-value < 0.01), and macrosomia (P-value < 0.01). The main causes of PPH were uterine atony and obstetrical lacerations (P value < 0.01). Management was mostly by the use of non-pharmacological and pharmacological measures. The main adverse outcomes were shock and severe anaemia, with one case of nearmiss recorded. No maternal death was recorded. Conclusion: The prevalence of postpartum hemorrhage amongst primigravidae was high. The main causes of post-partum hemorrhage were uterine atony and obstetric lacerations. PPH was associated with uterine hypotonia, retained products and genital lacerations. No maternal mortality was recorded. These findings highlight the pressing need for good quality em ergency obstetric care and the availability of more accurate techniques of postpartum blood loss measurement. Secondly, hospitals need blood banks to manage patients with severe hemorrhage.

Postpartum Hemorrhage, Primigravidae, VEBL, Maternal, Death, BHD

Takang, W. , Florent, F. , Obichemti, E. and Fukara, O. (2022) Factors Associated with Postpartum Haemorrhage amongst Primigravidae Women; the Case of Two Hospitals within the Bamenda Health District. Open Journal of Obstetrics and Gynecology, 12, 793-813. doi: 10.4236/ojog.2022.128068.