Abstract: Background: Postpartum haemorrhage is an obstetric emergency that requires immediate recognition and intervention, to prevent serious morbidity and death. Its magnitude and associated factors after caesarean delivery have not been studied in our Centre.
Objective: This study aimed to evaluate the prevalence and associated factors of postpartum haemorrhage following caesarean section in a tertiary care hospital.
Methods: A retrospective case-control study of a cohort of women who gave birth by caesarean section after 28 weeks, from 1st June 2021 to 31st May 2023, who had blood loss ≥ 1000 ml, was carried out. Data from medical records, including baseline characteristics, obstetric, and perioperative findings were retrieved. All independent variables were analyzed using bivariate analysis, and the variables with an association were fitted into a multivariate logistic regression analysis. The results were displayed as frequency tables with odds ratio (OR) and 95% confidence interval (CI), and a p-value < 0.05 was considered significant.
Results: There were 2072 caesarean deliveries during the study period, of which 78 women had postpartum haemorrhage, giving a prevalence of 3.8%. The mean maternal age was 33.90±4.80 years, their mean gestational age at delivery was 36.69±2.49weeks, and their median parity was 1. Significant factors on bivariate analysis were placenta previa (P=0.027), abruptio placenta (P=0.012), stillbirth (P=0.008), additional procedure [repair of uterine incision extension and hysterectomy], (P=0.0001), duration of surgery (P=0.0001), and blood transfusion (P=0.0001).The surgery duration was two times more likely to last > 60 minutes and need for blood transfusion was four times more likely, in women with postpartum haemorrhage than their counterparts.
Conclusion: Postpartum haemorrhage after caesarean delivery was prevalent in our setting. Intraoperative factors such as duration of surgery, need for blood transfusion, and additional procedures (repair of uterine incision extension and hysterectomy) were significantly associated with postpartum haemorrhage.
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