The Prevalence and Risk Factors of Post-Partum Haemorrhage in Africa: A systematic review.

Abstract

Background Postpartum Haemorrhage is the loss of blood that is 500 ml or greater than 500ml following a vaginal delivery or blood loss that is more than or equivalent to 1000 ml post-caesarean section. Post-partum Haemorrhage is the leading cause of maternal mortality, and to our knowledge, there is less evidence of a systematic review being published on the prevalence and associated risk factors of PPH in Africa. Additionally, findings from previous studies about the prevalence and risk factors of PPH in Africa are controversial. Therefore, we aimed to assess the prevalence and risk factors of PPH in Africa, so as to provide scientific evidence base findings that might be used to ensure maternal safety. Methods: We conducted a systematic review of the prevalence and risk factors of Postpartum haemorrhage in Africa. Four electronic databases were searched for published observational and cross-sectional studies that reported on the prevalence and risk factors of PPH in Africa. Simple manual arithmetic calculation and descriptive critical reasoning were used to analyse pooled data on PPH prevalence and its associated risk factors in Africa. Results: A total of 2005 publications were retrieved from our search, out of which 162 articles were selected for full-text review. A total of 12 studies met the inclusion criteria for this systematic review. All the included studies reported relatively different prevalence rates of PPH in Africa, ranging from 1.13% in Nigeria to 23.63% in Cameroon. This Review found the overall prevalence rate of PPH in Africa to be 3.51%. Nearly all the studies provided similar associated risk factors of PPH in Africa, but these risk factors vary relatively in the magnitude of association from one country to another. Notwithstanding, this review found: spontaneous vaginal delivery, older maternal age, and multiparty to be associated with increased risk of PPH in Africa. Conclusion: We found that the PPH prevalence rate is lower than 4% in Africa and that its risk factors vary relatively in the strength of association from one geographical region to another. We suggest that future research focus on PPH prevention and control to ensure maternal and child safety.

Magnitude and Associated Predictors of Blood Loss and Perineal Integrity among Women Giving Birth at Serengeti District Hospital: A Cross-Sectional Documentary Review Study

“…The prevalence of obstetric blood loss varies significantly with the setting of the study; for example, 9.0%, 9.4%, and 16.6% in Uganda, Sidama regional state, and southern Ethiopia, respectively [7][8][9]. A systematic review study in Africa showed a prevalence rate of 3.51% [10]. Apart from the known causes of obstetric blood loss post-delivery, studies have reported such factors as maternal age, antepartum anemia, abnormal labor, history of obstetric hemorrhage post-delivery in the previous pregnancies, and instrumental deliveries, multiparity, prolonged labor, CS delivery, multiple pregnancy, and big baby, to contribute significantly to its occurrence [7][8][9][10][11].…”

A longitudinal study of incidence and mortality of postpartum hemorrhage at the Gambian tertiary hospital

“…Other risk factors include obesity, fever during pregnancy, bleeding before delivery, and heart disease. 2 A recent systemic review (2019) 6 on prevalence and risk factors of postpartum haemorrhage, found that the risk factors of PPH include: the use of assisted reproductive treatment (ART), Pregnancy Induced Hypertension, severe vaginal/perineal lacerations and macrosomia. Some scholars working in America, reported spontaneous delivery, caesarean section, forceps delivery, labour induction, non-use of oxytocin or other uterotonic agents in the third stage of labour, history of PPH, multiple pregnancies and fetal macrosomia as risk factors of PPH.…”