Immediate Postpartum Hemorrhage: Management Delays and Factors Associated with Maternal Mortality in A Referral Maternity Hospital

Abstract

Bah Oumou Hawa*, Bah IK, Sow IS, Diallo BA, Diallo MH, Diallo A, Balde IS and SY T

Introduction: Immediate postpartum hemorrhage (IPPH) remains one of the leading causes of maternal mortality in low-resource countries. However, most of these deaths could be prevented through adequate obstetric care. Timeliness of management is a major determinant of maternal survival.

Objective: To analyze management delays and factors associated with maternal mortality during immediate postpartum hemorrhage in a referral maternity unit.

Methods: A retrospective analytical study was conducted on cases of IPPH recorded in a university maternity hospital. Clinical data, intervention delays, and the profile of the involved healthcare personnel were analyzed.

Results: A delay of more than 30 minutes before initial medical intervention significantly increased maternal lethality (OR = 5.45; p = 0.001), whereas intervention within the first 10 minutes was highly protective (OR = 0.072; p < 0.001). A delay exceeding 120 minutes before surgical management markedly increased the risk of death (OR = 120; p < 0.001). Healthcare personnel qualification was not statistically associated with maternal lethality.

Multivariate analysis showed that maternal lethality due to postpartum hemorrhage was significantly associated with maternal age >35 years, incomplete antenatal care, admission by referral, and delivery by cesarean section.

Conclusion: Maternal mortality due to postpartum hemorrhage is strongly influenced by delays in response. The implementation of emergency protocols, reorganization of care, and rapid availability of surgical interventions are essential

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