DOI: 10.36347/sjams.2015.v03i01.041

Pages: 198-205

Primary postpartum hemorrhage (PPH) defined as blood loss in excess of 500 ml from the genital tract within the first 24 hours following vaginal delivery. PPH is a main cause of considerable maternal morbidity and mortality worldwide. The objective was to identify and quantify potential risk factors for the disease during 2009. Furthermore, to calculate the population attributable risk percentage for the most significant modifiable risk factor and to assess interaction. A hospital based case control study was done in Benghazi, Libya: 153 newly diagnosed cases of primary PPH admitted to Benghazi main hospital and an age matched group of 200 controls were randomly selected from the same hospital without PPH. Both cases and controls were subjected to a predesigned questionnaire. Significant risk factors for PPH were: previous caesarian section with OR 5.0; 95%CI(2.0-13.0), pregnancy induced hypertension with OR 4.0; 95% CI (1.8-10.6), blood transfusion after labor with OR 26.0; 95%CI (7.8-85.0), previous PPH, OR 2.6; 95% CI (1.15-6.1) posterior placenta, OR 2.0, 95% CI(1.2-3.5) and irregularity of antenatal visits with OR 2.0; 95% CI(1.18- 3.7). Population attributable risk percent was calculated for modifiable risk factors and arranged in ascending manner: Regularity of booking =6%, Pregnancy induced hypertension =7%, Anaemia=13%, API (Attributable Proportion of interaction) =64%, Rothman index >3.25 indicated a synergistic effect. Adapted regular booking, management of pregnancy induced hypertension and management of anaemia could prevent postpartum haemorrhage. Education programs focusing on the modifiable risk factors are required in particular with improvements MCH services.