Onyema Onyegbule A, Cornelius Amajuoyi C, Uchenna Ejelonu T, Duke Onyeabochukwu A
Niger J Med. 2015 Jul-Sep;24(3):242-5.
Primary postpartum hemorrhage is an obstetric emergency and is a leading cause of maternal morbidity and mortality in developing countries. It a condition that requires vigilance, prompt and appropriate management.
To determine the prevalence and determinants of primary post partum haemorrhage in Federal Medical Centre Owerri.
All cases of all cases of primary post partum haemorrhage managed at FMC Owerri. The case notes were retrieved from the hospital's Records Department and information on socio-demographic characteristics, nature of labour (spontaneous, induced or augmented) duration of labour and mode of delivery and birth weight, estimated blood loss and the need for blood transfusion were obtained.
Out of a total of 4889 deliveries, 3725 (76.2%) women had vaginal delivery while 1,164 (23.8%) women had caesarean section. Out of these deliveries, 166 women had Primary Post Partum Hemorrhage (PPH), giving a prevalence of 3.4%. Multiparous women had higher prevalence compared to nulliparas: 88 (48.3%) versus 37 (22.2%) respectively. The commonest cause of primary PPH was uterine atony 72 (43.4%) and cervical laceration was the least cause constituting 13 (7.7%). Caesarean section was associated with higher prevalence of post partum haemorrhage, 94 (56.4%). Duration of second and third stages of labour lasting more than 30 minutes and 10 minutes respective were associated with higher risk of primary PPH:82 (49.5%) and 87 (52.3) respectively.
Supervised antenatal care, active management of labour and emergency obstetric care, if employed religiously will drastically reduce post partum haemorrhage and thus its associated complications.
原发性产后出血是一种产科急症，是发展中国家孕产妇发病和死亡的主要原因。这是一种需要警惕、及时且恰当处理的情况。
确定奥韦里联邦医疗中心原发性产后出血的患病率及决定因素。
奥韦里联邦医疗中心处理的所有原发性产后出血病例。从医院记录部门检索病例记录，并获取社会人口学特征、分娩性质（自然分娩、引产或加强宫缩）、产程、分娩方式、出生体重、估计失血量及输血需求等信息。
在总共4889例分娩中，3725例（76.2%）妇女经阴道分娩，1164例（23.8%）妇女行剖宫产。在这些分娩中，166例妇女发生原发性产后出血（PPH），患病率为3.4%。经产妇的患病率高于初产妇：分别为88例（48.3%）和37例（22.2%）。原发性PPH最常见的原因是子宫收缩乏力，72例（43.4%），宫颈裂伤是最少见的原因，占13例（7.7%）。剖宫产与产后出血的较高患病率相关，94例（56.4%）。第二产程和第三产程持续时间分别超过30分钟和10分钟与原发性PPH的较高风险相关：分别为82例（49.5%）和87例（52.3%）。
如果严格采用产前监护、积极的分娩管理和产科急诊护理，将大幅减少产后出血及其相关并发症。
