Journal of Genital System & DisordersISSN: 2325-9728

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Research Article, J Genit Syst Disord Vol: 6 Issue: 3

Postpartum Hemorrhage and Active Management of the Third Stage of Labor (AMTSL) in a Sub-Saharan Africa Maternity

Kouamé AD1*, Kakou KFC1, Adjoby CR1, Koffi A1, Mian DB1, Koffi SV1, Diomandé FA1, KASSE Raoul K1 and Kouakou F1,2

1Obstetrics and Gynecology Department, University Hospital of Cocody, Abidjan, Ivory Coast

2Manager of Obstetrics and Gynecological Emergencies department of University Hospital Center (UHC) of Cocody, Abidjan, Ivory Coast

*Corresponding Author : Dr. Kakou Charles
Department of Gynecology and Obstetrics, Cocody University Hospital, University Felix Houphouet Boigny, 06 Po Box 296 Abidjan 06, Ivory Coast
00 (225)22481050
Fax: 00 (225)22442379

Received: September 15, 2017 Accepted: October 04, 2017 Published: October 09, 2017

Citation: Kouamé AD, Kakou KFC, Adjoby CR, Koffi A, Mian DB, et al. (2017) Postpartum Hemorrhage and Active Management of the Third Stage of Labor (AMTSL) in a Sub-Saharan Africa Maternity. J Genit Syst Disord 6:3. doi: 10.4172/2325-9728.1000177


Objective: To assess why the prevalence of postpartum hemorrhage still high while applying active management of the third stage of labor procedure.

Material and methods: It was a retrospective comparative study that lasted for forty-two months period, from July 1st, 2011 to December 31, 2014 about 7466 deliveries. We divided the patients into 2 groups. The case group encompassed all patients for whom the AMTSL procedure was executed. The control group was made of patients who did not receive AMTSL procedure.

Results: During the study period, we registered 7466 vaginal deliveries. The prevalence of postpartum hemorrhage reached 3.7%. For the population that benefited from controlled cord traction for placental extraction, the prevalence was 2.9% whereas those who have not benefited from controlled cord traction presented a postpartum hemorrhage in 09.76% therefore three times higher (p<0.00001). The most represented age group was 20-34 years old (76.7% for cases and 74.5% for controls). The nulliparous constituted 32.6% of cases while the multiparous were 32.2% of controls. In over half of the cases, they have been referred (56.5% for cases and 52.9% of controls). The delivery delay was inferior to 5 minutes with 71.75% of cases against 33.35% of controls (p<0.00001). Atony was the prevailing etiology in both groups (78.8% for cases and 65.5% for controls). Postpartum haemorrhage was lethal in 3.2% of cases with controlled cord traction against 17.2% without controlled cord traction making 5 times higher (p<0.00001). The main etiology of death was coagulopathy.

Keywords: Postpartum, Hemorrhage-active management, Labor-maternal mortality

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