assessment was made by estimation of Hb levels, need for blood transfusions, clinical condition of the patient
In this study, case notes of women who delivered in the hospitals were further explored to identify the women with primary PPH and 70 women were identified. Therefore, the result of this study focused on the 70 cases of women with primary PPH during one year of the study period. For most of the PPH cases in the tertiary institution, the women were mostly non-booked or referred from primary health care centers and private hospitals i.e 45 (64.3%) patients. From the information in the case notes referrals were made when patients had obstructed labor, the prolonged first or second stage of labor, and fetal distress due to meconium staining of liquor. Only 25 (35.7%) women had antenatal care at our institution (booked cases). The age range of the women was between 22 and 42 with a mean age of 29±6 years.
A chi-square test reflected a significant association between booking status 25 (35.7%) and occurrence of PPH (χ2 = 5.714, df = 1, p=0.017). The leading associated risk factors for primary PPH were high parity 18 (25.7%), and anemia 11 (15.7%) followed by birth weight >4 with or without polyhydramnios 9 (12.8%), and multiple pregnancies 8 (11.4%). Others include antepartum haemorrhage 7 (10%), previous history of PPH, 5 (7.1%), preeclampsia 6 (8.5%), chorioamnionitis 4 (5.7%), and abnormal lie/presentation 3 (4.2%). In addition, uterine atony was the most common etiological factor 54 (77.1%) for primary PPH followed by the retained placenta and retained placental tissue in 7 (10%) patients. Other etiologies included