Incidence and risk factors of postpartum hemorrhage in the north-west bank of Palestine

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Eman Alshawish
Shaima abd al- Kareem sabbagh
Razan Bassam Ahmed
Amal alaa al-deen sleem
Sara Ahmad Yonis Said
Lena Farooq Nawahda
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▪ Introduction :- Pregnant women can experience many complications during labor and especially at the third stage of labor and post-delivery that affect her health and her newborn, there are many causes for these complications such as postpartum hemorrhage (PPH). which remains a leading cause of maternal deaths, and we did this study for Measuring the incidence of PPH and Identifying the risk factors which may contribute to PPH. ▪ Methods: A Quantitative retrospective study , was conducted at four health facilities in north west bank of Palestine (Dr Khaleel sliman governmental hospital , Al-shaheed Yasir Arafat governmental hospital, Rafeedia governmental hospital , Al-shaheed thabet thabet governmental hospital) , Data collected by using computerized files of postnatal women with PPH and the file that met inclusion criteria which it is 100 women , checklist filled and reviewed by researchers then another 100 files without PPH selected randomly for comparison . ▪ Results: Among 5500 deliveries occuring between (june 2020 - july 2021) we identified 100 cases complicted of PPH and another 100 cases not complicated with PPH chose randomly. the incidence of PPH is 1.8% , the main cause of PPH is uterine atony (64%),then retaned placenta (25%),The frequency of PPH is significantly associated with age (P-value = 0.000 ), BMI (p-value = 0.004), Education level (p-value = 0.000), gravity (p-value = 0.013), have a History of previous PPH ( p value = 0.000) , and History of uterine fibroma (p-value = 0.003), Hypertension (p-value = 0.003) , Diabetes mellitus (p-value = 0.027) , Anemia (p 6 value = .0000), Preeclampsia (p-value = .017) , Coagulation disorders (p-value = .001) , Placenta disorders like placenta previa & abruptio placenta (p-value = .002) , prolong labor & precipitous delivery (p-value = .000) , Multiple pregnancy (p-value = .03) , Type of delivery (p-value = .0000) had high risk of PPH. ▪ Conclusion: The study showed that women aged more than 18 is more risk for PPH, increasing of BMI increased the risk of PPH, women with low educational level is high risk of PPH, increasing parity increased risk of PPH, women with Previous history of PPH or uterine fibroma is high risk of PPH, women who had hypertension, diabetes mellitus, preclampisa, anemia and coagulation disorders had high risk of PPH, Women with abruptio placenta and placenta previa is higher risk than normal placenta, CS delivery is higher risk of PPH than NSVD and instrumental delivery, Prolong and precipitous labor more risk than normal duration of labor, Multiple pregnancy More risk of PPH, finaly the study showed that antenatal visit, weight of baby and gastational age didn’t have relationship with PPH.