مجلة الاطروحة العلمية المحكمة الاطروحه للنشر العلمي
وفيات الأمهات بسبب نزيف ما بعد الولادة في العراق (2015-2017)
د. اسمهان عبد الكاظم قاسم
د. حوراء باسمن جواد
دائرة صحة الكرخ / بغداد / العراق
Abstract:
Background: According to the world health organization, obstetrics hemorrhage causes 127,000 deaths annually worldwide and is the leading cause of maternal mortality. The current study aimed to thoroughly analyze the reported maternal deaths due to PPH, to identify factors associated with the occurrence of PPH.Methods: A cross sectional study was carried out at the Maternal and Child Health (MCH) Section, Public Health Directorate, MOH, Iraq, from Feb. to Jun, 2018. All records of maternal death during 2015-2017 that were available at the MCH section were reviewed and those who died because of PPH were retrieved and analyzed.Results: PPH as a cause of maternal death in Iraq during the period (2015-2017) ranged from 16.7 % among all reported maternal deaths during 2015 to 26.9% during 2016 and 20.1% during 2017. Half of women who passed because of PPH were among the young age group (20-35 years), 56.2% lived in urban areas, more than one third were from Baghdad city, 45.8% of the deceased women did not attend ANC services, 64.2% of them delivered their babies at hospitals, 87.1% of deaths took place at hospitals, uterine atony was the first cause for developing PPH 27.4%, delay 1 was on the top of the list (alone 31.3%, combined with other delays 70.2%), grand multiparous was the first risk reported in 31.8% of the records.Conclusion: Among all deceased during 2015-2017, PPH was the cause of death in 20.2%. PPH was higher among those aged 20-35, with low educational level, from urban residency, grand multiparous, with no ANC during pregnancy, more than 37 weeks of gestation. Uterine atony was the first cause of PPH followed by traumas (Cervical tear and ruptured uterus) and the least was placental complications. D1, alone or combined with others, was on the top of the list followed by D3 which indicated substandard care.
Keywords: Maternal Deaths, Postpartum Hemorrhage, Iraq, (2015-2017).