A STUDY TO DETERMINE THE PREVALENCE OF POST-PARTUM HAEMORRHAGE AMONG MOTHERS AT ISHAKA ADVENTIST HOSPITAL, BUSHENYI DISTRICT, UGANDA.

TABLE OF CONTENTS

DECLARATION…………………………………………………………….….ii

DEDICATION…………………………………………………………………..iii

ACKNOWLEDGEMENTS…………………………………………………….iv

TABLE OF CONTENTS………………………………………………………..v

LIST OF TABLES…………………………………………………………….viii

LIST OF FIGURES……………………………………………………………..ix

LIST OF ABBREVIATIONS…………………………………………………..x

OPERATIONAL DEFINATIONS…………………………………………….xi

APPENDICES………………………………………………………………….xii

APPENDIX I: RESEARCH CHECKLIST……………………….xii

APPENDIX II: MAP OF BUSHENYI……………………………..xii

APPENDIX III: MAP OF UGANDA………………………………xii 

APPENDIX IV: INTRODUCTORY LETTER……………………xii

ABSTRACT…………………………………………………………………….xiii

CHAPTER I: INTRODUCTION………………………………………………..1

1.1: BACKGROUND…………………………………………………………….1

1.2: PROBLEM STATEMENT…………………………………………………3

1.3: OBJECTIVESOF THE STUDY……………………………………………4

1.3.1: GENERAL OBJECTIVES……………………………………………….4

1.3.2: SPECIFIC OBJECTIVES……………………………………………….4

1.4: RESEARCH QUESTIONS………………………………………………….4

1.5: SCOPE OF STUDY………………………………………………………….4

vii

1.6: SIGNIFICANCE OF THE STUDY…………………………………………5

1.7: CONCEPTUAL FRAMEWORK…………………………………………...5

1.7.1: DESCRIPTION OF CONCEPTUAL FRAMEWORK………………….6

CHAPTER II: LITERATURE REVIEW………………………………………..7

2.1: INTRODUCTION…………………………………………………………….7

2.2: LITERATURE REVIEW……………………………………………………7

CHAPTER III: METHODOLOGY……………………………………………..12

3.0: INTRODUCTION…………………………………………………………...12

3.1: AREA OF STUDY…………………………………………………………...12

3.2: STUDY DESIGN………………………………………………………….…13

3.3: STUDY POPULATION……………………………………………….…….13

3.4: SAMPLE SIZE ESTIMATION…………………………………………….13

3.5: SAMPLING TECHNIQUES……………………………………………….14

3.6: DATA COLLECTION……………………………………………………...14

3.7: DATA ANALYSIS…………………………………………………………..14

3.8: DATA PRESANTATION…………………………………………………..14

3.9: INCLUSION CRITERIA…………………………………………………...15

3.10: EXCLUSION CRITERIA…………………………………………………15

3.11: ETHICAL CONSIDERATION…………………………………………...15

3.12: LIMITATION AND DELIMITATIONS OF STUDY…………………...15

CHAPTER IV……………………………………………………………………..16

4.1: STUDY FINDINGS………………………………………………………….16

4.2: SOCIODEMOGRAPHIC DATA…………………………………………..16

4.3: CAUSES OF PPH……………………………………………………………17

4.4: MANAGEMENT STRATEGIES…………………………………………..18

CHAPTER V………………………………………………………………………20

5.1: DISCUSSION OF FINDINGS……………………………………………….20

5.2: DEMOGRAPHIC DATA…………………………………………………….20

5.3: CAUSES OF PPH……………………………………………………………..20

5.4: MANAGEMENT STRATEGIES……………………………………………21

5.5: OUTCOME OF MANAGEMENT…………………………………………..23

5.6: SUMMARY……………………………………………………………………24

5.7: CONCLUSION………………………………………………………………..24

5.8: RECOMMENDATIONS……………………………………………………..24

REFERENCES……………………………………………………………………..26

APPENDICES………………………………………………………………………28

APPENDIX I: RESEARCH CHECKLIST………………………………………28

APPENDIX II: MAP OF BUSHENYI…………………………………………….29

APPENDIX III: MAP OF UGANDA……………………………………………...30

APPENDIX IV: INTRODUCTORY LETTER…………………………………...31

ABSTRACT 

A retrospective study was carried out at Ishaka Adventist hospital (IAH), Ishaka town, Bushenyi district, at identifying the prevalence of post-partum hemorrhage among mothers who attended. All files/ records were reviewed dating a year back from the day of actual data collection (i.e. from May 2013 to May 2014, total of 100 files were picked out from which the patients with the required data were reviewed. Postpartum Haemorrhage (PPH) is defined as a blood loss of 500 ml or more within 24 hours after birth. PPH is the leading cause of maternal mortality in low-income countries and the primary cause of nearly one quarter of all maternal deaths globally. Most deaths resulting from PPH occur during the first 24 hours after birth: the majority of these could be avoided through the use of prophylactic uterotonics during the third stage of labour and by timely and appropriate management. In this setting, the most affected age group was that between 20-29 having a cumulative frequency of 53%. This was associated with a low educational status(54% of respondents). Globally, uterine atony is the major cause of PPH. Our research established a higher prevalence of Retained Products of Conception (RPOC) coupled with trauma. There is also an association between grand multiparity and occurance of PPH. The popularity of management options vary from usage of both uterotonics plus other methods used to achieve hemostasis (46.19%), use of uterotonics only (22.34%), while a small portion (2.03%) needed hysterectomy. The prognosis was good for the majority (89%) of the mother. As a public health concern, emphasis should be made on community sensitization on the importance of having a planned hospital delivery, provision of safe and quick emergency medical help, the reduction in hospital costs as well as provision of accessible medical help to facilitate a quick help, hiring of more qualified personnel capable of handling such emergencies and the training of more traditional birth attendants because they are the ones in closer contact with the community and can, therefore, provide more immediate help.