Assessment of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: A Cross-Sectional Study

Abstract

Objective

Despite implementation of different strategies, postpartum hemorrhage (PPH) continued to account for a substantial proportion of maternal deaths in Ethiopia. The objective of this study was to assess the magnitude of PPH and its associated factors among women who gave birth in a university hospital in eastern Ethiopia from 1 to 31 March 2020.

Methods

An institution-based cross-sectional study was conducted. A review of 653 randomly selected medical records of all deliveries from 1 March 2018 to 29 February 2020 in Hiwot Fana Specialized University Hospital (HFSUH), a university hospital in eastern Ethiopia, was conducted. Data were collected on sociodemographic characteristics, obstetric and reproductive health conditions, and presence of PPH. Data were coded, checked for completeness and entered using EpiData 3.1 and exported to SPSS 20 for analysis. Results were expressed using frequencies, tables and figures. Binary and multiple logistic regression were fitted to identify factors associated with PPH and associations were described using adjusted odds ratio (aOR) along with 95% confidence intervals (CI). Associations with p<0.05 in the multivariable logistic regression were declared as statistically significant.

Results

From a total of 642 (98.3%) women included in this study, 83 (12.9%; 95% CI 10.4–15.6) had PPH. Maternal age >35 years (aOR = 3.08; 95% CI 1.56, 6.07), no antenatal care (aOR = 3.65; 95% CI 1.97, 6.76), history of PPH (aOR = 4.18; 95% CI 1.99, 8.82), and being grand multigravida (aOR = 3.33; 95% CI 1.14, 9.74) were significantly associated with having PPH.

Conclusion

A high proportion of women who gave birth in HFSUH experienced PPH. Prevention and management of PPH should focus on improving antenatal care and prioritize grand multigravida, older women, and women with a previous history of PPH.

Keywords:

• magnitude
• morbidity
• mortality
• postpartum hemorrhage
• PPH

Authorship Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Acknowledgments

We would like to thank Hiwot Fana Specialized University Hospital administrators for facilitation of the study. We are also grateful to the supervisors and data collectors for their support.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The work was funded by Haramaya University as part of a MSc study to SM. The organization has no role in the design, collection, analysis or interpretation of data or the decision to submit for publication.