Postpartum Hemorrhage: Epidemiology and Management Issues in a Context of Limited Resources: Case of the Laquintinie Hospital in Douala, Cameroon

Abstract

Introduction: Primary postpartum hemorrhage is blood loss greater than or equal to 500 ml occurring within 24 hours following delivery regardless of the route of delivery. It is the leading cause of maternal death worldwide. Objective: This work was to determine the epidemiological, clinical and therapeutic aspects of postpartum hemorrhage at Laquintinie Hospital in Douala. Methodology: We conducted a descriptive cross-sectional study for 5 months (December 1, 2017, to April 30, 2018). Our study population consisted of all external and internal births who presented with hemorrhage in the immediate or late postpartum period. The statistical analysis was carried out using the epi info software version 3.5.4; the chi square test and a 95% confidence interval were used. Results: The frequency of postpartum hemorrhage was 10.2%. The average age of the patients was 28.6 ± 5.7. They were mainly housewives (49.1%), married (45.5%), with secondary education (60.7%), residing in urban areas (97.3%) and primiparous or pauciparous (33.9%). Anemia in pregnancy was found in 52.7% of cases. The deliveries were at term (84.8%), cases by vaginal route in 83.9% of cases. In 37.5% of cases, utero tonics were used during labor. Most patients were evacuated (83.2%). Primary postpartum hemorrhage (86.6%) was most frequently encountered and uterine atony represented the main etiology (36.6% of cases). In 50.9% of cases, blood loss was unclear. Surgical treatment was required in 34.8% of cases. Anemia was the main complication observed with a maternal mortality rate of 3.5%. Conclusion: Postpartum hemorrhage is common at Laquintinie Hospital in Douala. Uterine atony is the main etiology of hemorrhages. Anemia represents the most common complication.