| dc.description.abstract | Background: Postpartum hemorrhage is one of the leading causes of severe maternal morbidity
and mortality; accounting for 27.1% of maternal deaths worldwide, ranging from 8% in developed
countries to 32% in Northern Africa. In Uganda, postpartum hemorrhage accounts for 34% of the
maternal deaths. Despite being a treatable and preventable condition, the high number of maternal
deaths resulting from postpartum hemorrhage has remained a significant worldwide concern. This
study aimed to establish the prevalence and factors associated with PPH following cesarean section
among mothers delivered from Kawempe National Referral hospital.
Methods: This was a cross sectional study conducted at Kawempe National Referral Hospital. A
total of 247 participants (women of reproductive age group 15-49 years) were recruited using
systematic sampling and following attainment of informed consent. Study period from 1
st
December 2023-30th January 2024. PPH was defined as blood loss of >1000mls during or after
cesarean delivery or any amount of bleeding that led to hemodynamic instability characterized by
shock index > 0.7 or hemorrhage that necessitated blood transfusion, hemostatic sutures (O’Leary,
Cho and B lynch) or hysterectomy.
Data was collected using a pretested interviewer-administered questionnaire, entered in EpiData
version 7.1.2, cleaned, and exported to Stata v15 for analysis.
Results: Among the 247 mothers that were recruited into the study, the average age was 27.98
(±5.64). Majority were Baganda (46.6%), 93.1% were married and 49.0% had attained secondary
education. The prevalence of PPH among post caesarean section mothers was found to be 18.2%
with Atony accounting for 73.3%, coagulation disorders (17.8%), trauma (13.3%) and retained
tissue (8.8%). PPH following C/section was found to be significantly associated with anaemia
during pregnancy (aOR=5.212, 95% CI 1.713 - 15.855, P-Value 0.004), history of pre-eclampsia
(aOR=3.803, 95% CI 1.403 - 10.311, P-value 0.009) and increase in shock index > 0.7
(aOR=75.506, 95% CI 10.424 - 546.937, P-Value <0.001).
Conclusion: Mothers with anemia and hypertensive disorders should be identified during
antenatal and optimized to minimize intrapartum complications. In the event of pre or intra
operative diagnosis, management should be tailored to account for the risk of massive
intraoperative bleeding and a multidisciplinary team alerted and prepared to minimize morbidity and/or mortality | en_US |
