Author(s): Ngbale RN, KOIROKPI A, GODDOT NANGOUMA NMJ, GAUNEFET EC, SONGOKETTE T
Hemorrhage immediate postpartum period, one of the causes of maternal mortality remains a major concern in developing countries such as Central African Republic (CAR). In this work, we wanted to study the epidemiology of bleeding the immediate postpartum very poorly equipped medical area to propose steps to improve its therapeutic management. To do this, we have set the following objectives: to determine the frequency of bleeding the immediate postpartum period; describe the epidemiological characteristics; identify the causes of bleeding; assess the maternal prognosis. This is a transversal and descriptive study conducted over ten months (1 September 2009 to 30 June 2010) at the maternity of the University Regional Hospital Bossangoa. Were included in the study all patients with hemorrhage immediate postpartum regardless of place of birth. We identified 52 cases of hemorrhage of the immediate postpartum period for 496 births, a rate of 10.4%. The average age of patients was 24.5 years, with extremes of 15 and 40. The age group most affected age was 15 to 19 years (32.6%). The mean parity was 3.4 with 42.3% of multiparous. In 67.3% of cases, the delivery was performed by the matrons-midwives. Blood transfusion was performed in 26.9% of patients. The primary cause of bleeding of the immediate postpartum period was retained placenta (53.8%), followed by home births in 34.6% of cases. Among those who had given birth at home, the transfusion was required for 61.1% of them. We recorded four maternal deaths including 3 7.6% after the home birth. Hemorrhage immediate postpartum period remains a serious problem in the Regional University Hospital of Bossangoa. The home birth and lack of qualified personnel were contributing factors. Strengthening the semi-rural area capacity can reduce this morbidity.