Maternal mortality related to postpartum hemorrhage: a case-control study at the Befelatanana maternity of Madagascar

Authors

  • Rakotozanany Besaina Department of Obstetrics and Gynecology, Faculty of Medicine, Antananarivo, Madagascar
  • Randriamahavonjy Romuald Department of Obstetrics and Gynecology, Faculty of Medicine, Antananarivo, Madagascar
  • Rabearizaka Laingo Department of Public Health, Faculty of Medicine, Antananarivo, Madagascar
  • Ratsiatosika Tanjona Department of Public Health, Faculty of Medicine, Antananarivo, Madagascar
  • Randriambelomanana J. A. Department of Obstetrics and Gynecology, Faculty of Medicine, Antananarivo, Madagascar

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20185406

Keywords:

Associated factors, Maternal mortality, Postpartum hemorrhage

Abstract

Background: Postpartum hemorrhage (PPH) remains the main cause of maternal death throughout the world. present goal was to determine the associated factors to maternal death in postpartum hemorrhage.

Methods: This was a retrospective case-control study; carried out within Befelatanana maternity, in Antananarivo, from January 1st, 2013 to December 31st, 2015, on parturients who presented PPH. The cases were represented by the parturients who died despite well-managed care, and the control, by the living parturients.

Results: Authors recorded 181 cases of PPH from 20,888 deliveries, with a prevalence of 0.86%; 47 of them died and 134 were alive; the mortality rate by PPH is 25.96%. Factors associated with death were low education (p=0.00 OR:3.2), non-working (p=0.01, OR:2.4), multiparity ( p:2.2 OR:0.01), absence of prenatal care (p:0.01 OR:2.2), cesarean section (p:0.00 OR:5.5); Intrauterine Fetal Death (p= 0.02, OR:2.2); uterine atony (p=0.03, OR 2.1); the state of shock (p=0.00 OR:57.8), sanitary evacuation (p=0.01 OR: 2.4), the need for blood transfusion (p=0.00 OR: 3, 7), use of catecholamines (p=0.00, OR:17.5); delayed management (p=0.01, OR:2.2), hemostasis hysterectomy (p=0.00 OR: 8.67).

Conclusions: The decrease of maternal mortality related to PPH requires better monitoring of pregnancy, delivery and postpartum. Speed care management, improvement of technical platform and establishment of a powerful health system are also needed. Thus, the global reduction of poverty is indispensable.

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Published

2018-12-26

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Original Research Articles