Prevalence and predictors of primary postpartum hemorrhage: An implication for designing effective intervention at selected hospitals, Southern Ethiopia

Kebede, Biruk Assefa; Abdo, Ritbano Ahmed; Alemu, Abebe; Gebremariam, Beminet Moges

doi:10.1371/journal.pone.0224579

Cited by 70 publications

(98 citation statements)

References 24 publications

(49 reference statements)

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“…This is in contrast with the findings of Natakorn et al, [37] Sittiparn and Siwadune [8] confirming that advanced women age (greater than 35 years) is a PPH risk factor. Our findings also are in accord with a study conducted in Ethiopia to describe the prevalence and predictors of primary PPH, [58] which suggested that maternal age of or greater than 35, complicated labor, PPH in previous pregnancies and deliveries performed with aid of instruments were also predictors of primary PPH. Durmaz and Komurcu [57] recommended that midwives, nurses and obstetricians should cautiously monitor women who present with specific characteristics that are significantly associated with PPH during the antepartum, intrapartum and post-partum period.…”

Section: Risk Factors Associated With Pphsupporting

confidence: 91%

Factors affecting the prevention of postpartum hemorrhage in Low- and Middle-Income Countries: A scoping review of the literature

Bazirete

Nzayirambaho

Uwimana

et al. 2020

JNEP

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Background and objectives: Postpartum hemorrhage is an important cause of maternal mortality worldwide. A host of literature highlights the difficulty in predicting which women will experience Postpartum hemorrhage. The present study aims at describing the research output on factors affecting the prevention of Postpartum hemorrhage in Low- and Middle- Income Countries.Methods: A total of 24 published research articles and 2 papers from grey literature published between 2010 and 2019 were retrieved from PubMed, Scopus, CINAHL and Nursing and Allied Health Database (ProQuest). Data were extracted based on main study features and the findings were described narratively. Arksey and O’Malley’s framework for scoping studies was used in this review.Results: Findings from the literature from Low- and Middle- Income Countries are grouped into three themes: Knowledge and understanding about the prevention of Postpartum hemorrhage; Postpartum hemorrhage risk factors among childbearing women; and use of prophylactic uterotonic drugs for PPH prevention and related policies. The majority of studies investigate pharmacological interventions for PPH prevention, while few address the early assessment of risk factors associated with Postpartum hemorrhage for proactive prevention.Conclusions: The present study suggests that assessing risk factors associated with PPH would be a practical method for early identification of clients at high-risk for developing Postpartum hemorrhage. The present scoping review highlights the paucity of research considering Postpartum hemorrhage risk factors in low- and middle- income countries, particularly in Rwanda. Further qualitative research on the perceptions of health care workers and beneficiaries about Postpartum hemorrhage risk factors is warranted, to enable the development of a tool to assess risk factors associated to Postpartum hemorrhage among childbearing women in Low- and Middle- Income Countries.

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Section: Risk Factors Associated With Pphsupporting

confidence: 91%

Factors affecting the prevention of postpartum hemorrhage in Low- and Middle-Income Countries: A scoping review of the literature

Bazirete

Nzayirambaho

Uwimana

et al. 2020

JNEP

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“…Indicators of excess weight in terms of BMI or pregnancy Weight gain especially coupled to older pregnancy age increase preterm risk [16,17]. It is noteworthy that besides the social status, the high incidence of hemorrhage in this group of women, reaching 29% that is higher even in comparison to some countries of lower national income [18] led to the highest adjusted odds ratio for PTB of 6.88 to 10.24 (95% interval).…”

Section: Discussionmentioning

confidence: 98%

Nomogram to Early Screen Multiparous Women for Preterm Birth in a Cohort Study

Traboulsi

Talibi

Boussaid

2020

Preprint

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Background: Preterm Birth (PTB) can negatively affect the health of mothers as well as infants. Prediction of this gynecological complication remains difficult especially in Middle and Low-Income countries because of limited access to specific tests and data collection scarcity. Multiparous women in our study presented a higher PTB prevalence compared to nulliparous women. Methods: In a cohort study from Northern Lebanon of 1996 women, 922 were multiparous presenting a PTB prevalence of 8%. We analyzed the personal, demographic, and health indicators available for this group of women. We compared 4 modified logistic regression models (up-sampling, lasso penalized regression) to develop a nomogram that can screen for preterm in multi-parous women. The models were validated on a separate set of data.Results: The best PTB prediction of the Logistic regression model reached around 88%. This was obtained using a Logistic Regression Model trained on up-sampled datasets and LASSO (Least Absolute Shrinkage and Selection Operator) penalized. The regression coefficients of the 6 selected variables (Pre-hemorrhage, Social status, Residence, Age, BMI, and Weight gain) were used to create a nomogram to screen multiparous women for PTB risk. Conclusions: The nomogram based on readily available indicators for multiparous women reasonably predicted most of the at PTB risk women. This tool will allow physicians to screen women and run furthermore adequate additional tests leading to better medical surveillance that can reduce PTB incidence.

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“…The definition of primary postpartum haemorrhage (PPH) is that of blood loss from the genital tract of ≥500 mL or more following a normal vaginal delivery or ≥1,000 mL or more following a cesarean section within 24 hours of delivery as evidenced by a rise in the pulse rate, and falling blood pressure [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for composite adverse outcomes of postpartum haemorrhage, Mpilo Central Hospital, Bulawayo, Zimbabwe

Ngwenya

2020

F1000Res

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Background Globally, primary postpartum haemorrhage continues to cause considerable maternal morbidity and mortality. The aim of this study was to determine the risk factors for composite adverse outcomes of postpartum haemorrhage. The findings could potentially be used to anticipate and prevent composite adverse outcomes of postpartum haemorrhage. Methods This was a retrospective cross-sectional study carried out at Mpilo Central Hospital, a government tertiary referral centre, covering the period 1 July 2016 to 30 November 2019. Participants were included in the study if they had a diagnosis of postpartum haemorrhage. Those variables that had a p<0.2 from the univariate logistic regression analyses were considered for multivariable logistic regression. The association between independent variables and the dependent variable was assessed using odds ratio with 95% confidence intervals, to identify independent risk factors for composite adverse outcomes in PPH. A p< 0.05 was taken as statistically significant. Results The independent risk factors for composite adverse outcomes of postpartum haemorrhage were place of dwelling (AOR 4.57, 95% CI 1.87-11.12, p=0.01), prior Caesarean section (AOR 2.57, 95% CI 1.10-6.00, p=0.03), antepartum haemorrhage (AOR 5.45, 95% CI 2.23-13.27, p<0.0001), antenatal haemoglobin level (AOR 19.64, 95% CI 1.44-268.50, p=0.03), and current delivery by Caesarean section (AOR 10.21, 95% CI 4.39-23.74, p<0.0001). Blood loss was also an independent risk factor for composite adverse outcomes of postpartum haemorrhage with the following blood loss; 1001-1500ml (AOR 9.94, 95% CI 3.68-26.88, p<0.0001), 500-1000ml (AOR 41.27, 95% CI 11.32-150.54, p<0.0001), and 2001ml (AOR 164.77, 95% CI 31.06-874.25, p<0.0001). Conclusion This study found that the independent predictors for composite adverse outcomes of PPH were rural dwelling, prior Caesarean section, antenatal haemoglobin level, current delivery by Caesarean section, and blood loss. In low- and middle-income countries such information could help in increasing clinical vigilance and policy making, and preventing maternal deaths.

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Prevalence and predictors of primary postpartum hemorrhage: An implication for designing effective intervention at selected hospitals, Southern Ethiopia

Cited by 70 publications

References 24 publications

Factors affecting the prevention of postpartum hemorrhage in Low- and Middle-Income Countries: A scoping review of the literature

Factors affecting the prevention of postpartum hemorrhage in Low- and Middle-Income Countries: A scoping review of the literature

Nomogram to Early Screen Multiparous Women for Preterm Birth in a Cohort Study

Risk factors for composite adverse outcomes of postpartum haemorrhage, Mpilo Central Hospital, Bulawayo, Zimbabwe

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