TITLE:
Management and Prognosis of Early Postpartum Hemorrhage in African Low Setting Health
AUTHORS:
Youssouf Traoré, Ibrahima Téguété, Amadou Bocoum, Mamadou Traoré, Seydou Dao, Marion Koko Bomini, Niani Mounkoro, Amadou Dolo
KEYWORDS:
Early Postpartum Hemorrhage, Risk Factors, Surgery, Maternal Death
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.1,
January
4,
2018
ABSTRACT: Early postpartum hemorrhage is one of the major causes of maternal death
in the world especially in developing countries. Its management often relieves
resuscitation that is often difficult to set up in our countries and sometimes
based on invasive and mutilate surgery. Objectives: The purpose of this
survey was to report frequency of this pathology, to describe its management
and the factors that influence the prognosis of early postpartum hemorrhage in
low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum
hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community
five health reference center of the district of Bamako. It took place from
January, 2015 to December, 2016. The study concerned all the cases of early
postpartum hemorrhage according to WHO definition. Statistical tests used were
X2 or Fisher test, its 95% confidence interval (CI95%), p
value was significant if Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885
deliveries). Sixty nine and one percent (69.1%) of patients have been blood
fluid transfused. Obstetric treatment dominated by uterine revision (30.7%).
Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%),
hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have
been the main practiced surgical operations. No satisfy blood transfusion need
was 26.9%. The main risk factors of early PPH were high parity (p = 0009; RR = 3.04; CI95% [2.80 - 5.11]), prolonged labor
(p = 0004; RR = 4.00; CI95% [3.06 - 10.02]), oxytocin/prostaglandin use (p = 0003;
RR = 1.47; CI95% [1.17 - 3.16]). Eleven of maternal occurred
(11.8%). Conclusion: Early postpartum hemorrhage is still a
severe event in developing countries especially. Its management sometime
consisted to invasive cares. Maternal prognosis that is influenced by
unsatisfied blood need and late management is marked by high lethality.