322Incidence, and mortality associated with primary postpartum haemorrhage following hospital births in northwest Ethiopia
Abstract Background Primary postpartum haemorrhage remains the primary cause of maternal mortality, in low-resource countries such as Ethiopia. National datasets about the incidence of primary postpartum haemorrhage are often limited, incomplete or unavailable. This study was designed to determine the incidence, mortality, and factors associated with primary postpartum haemorrhage following in-hospital births. Methods This was a cross-sectional study design, an audit of 1060 maternity care logbooks of discharged women. The data were abstracted December to May 2018/2019 using systematic random sampling. The tool used was the Facility Based Maternal Death Abstraction Form. Data were entered, cleaned then analysed using SPSS version 25. Bivariate logistic regression was fitted. Adjusted odds ratio with 95% confidence interval was used to determine the statistical significance. Results The incidence of primary postpartum haemorrhage was nearly 9.0% (95% CI: 6.91, 10.73). Of these, there was 7% maternal mortality. Unique to women in Ethiopia health facility referrals of women in labour (AOR: 2.13; 95% CI: 1.19, 3.80), birth attended by final year medical students (AOR: 3.59; 95% CI: 1.89, 6.84), women who were discharged as early as six hours following birth (AOR: 3.50; 95% CI: 1.24, 9.91) were associated with primary postpartum haemorrhage (p < 0.05). Conclusions The reported incidence of primary postpartum haemorrhage was relatively low, however, the associated deaths of women found was comparatively high. Key messages The increased maternal mortality appears to be directly related to the three delays model.