Magnitude and Risk Factors of Ante-partum Hemorrhage in Lemlem Karl Hospital, Tigray, Northern Ethiopia

Abstract

Antepartum Hemorrhage (APH) is a grave obstetrical emergency. APH continues to be a major cause of maternal and perinatal morbidity and mortality even in modern obstetrics. It is one of the most frequent emergencies. Vaginal bleeding in the third trimester complicates 2–5% of all pregnancies. It is considered an obstetric emergency because hemorrhage remains the most frequent cause of maternal and fetal deaths. It is a critical for the well-being of both the mother and fetus that the patient who presents with third-trimester bleeding be managed expediently. APH is bleeding from the genital tract after 20 weeks of gestation until delivery in developed nations and after 28 weeks in countries with low resource setting, lacking adequate neonatal facilities. The main causes of APH are: Placenta Previa (PP), Abruption–Placenta (AP) and others. This study was done to assess the magnitude and risk factors of Antepartum Hemorrhage in Lemlem Karl Hospital. A Hospital based retrospective, quantitative study was conducted from July, 2011–June 30, 2014, in the department of obstetrics Lemlem Karl hospital, Tigray, Northern Ethiopia. The number of mothers who were admitted after 28 weeks for delivery during the study years was included in the study; data were collected using check lists and analyzed using SPSS windows version 16.0. The proportions were calculated, Chi-square and logistic regression was run to test for associations. The magnitude of placenta previa and placental abruption in the study hospital during the study period was 1.04% and 0.34 per 1000 pregnant women. Placenta previa and placental abruption and other causes of Antepartum hemorrhage constituted: 26 (8.2%), 9 (2.4%) and 2 (0.6%), respectively. The maternal age ranged from 15 to 49 years with a mean age of 27.9 years. The parity ranged from 0 to 11 with a mean of 4. Recurrence of Antepartum hemorrhage, previous history of pregnancy induced hypertension, age >35, previous PROM and Chorio-amenities increased the risk factor by three fold in Antepartum hemorrhage cases than non Antepartum hemorrhage cases. AOR-0.63, AOR CI 95% (0.15–2.64), AOR 0.39, AOR CI 95% (0.08–1.86), AOR 0.35, AOR CI 95% (0.10–1.24), and AOR 0.30, AOR CI 95% (0.08–1.12), respectively. From this study the magnitude of Antepartum hemorrhage was 1.04% of the total deliveries whereas the magnitude of placenta previa and placenta abruption in this study became 26 (8.2%), 9 (2.8%), respectively. The most highly significant risk factors of placenta previa and abruption placenta were: multiparity, gestational age 28–36 weeks, duration of vaginal bleeding, prolonged hospital stay more than seven days, previous hypertension, recurrent Antepartum hemorrhage, previous delivery by caesarean section, male fetus, maternal travel more than 10 km and abdominal trauma, rural residence and maternal age greater than 35 were important risk factors. Therefore, early intervention, institutional delivery and strengthening of safe motherhood services, particularly in rural areas, will help to prevent and reduce the gravity of the situation.

Keywords: Ante-partum hemorrhage, magnitude, risk factors

Cite this Article

Berihun Adhena, Alemayehu Bayray, Aklil Alemayehu. Magnitude and Risk Factors of Ante-partum Hemorrhage in Lemlem Karl Hospital, Tigray, Northern Ethiopia. Research and Reviews: Journal of Immunology (RRJoI). 2015; 5(1): 13–22p.