Email this article 
Hide
Show all
Active management of third stage of labour, post–partum haemorrhage and maternal death rate in the Vanga Health Zone, Province of Bandundu, Democratic Republic of the Congo
Abstract
Objectives: To describe the practice of AMTSL in Vanga Health Zone and to calculate the incidence of PPH in Vanga Health Zone.
Method: An intervention study with post-test-only design was conducted among health maternity wards using a data collection sheet to obtain information. All pregnant women attending Vanga Health maternity wards constituted the study population. Frequencies were determined for variables of interest.
Results: From April 2007 to March 2008, 6339 deliveries took place at Vanga Health maternity wards, representing 71% of the institutional delivery rate. The number of deliveries realised with the practice of (AMTSL) were 5562; 366 cases of PPH were reported, making an incidence of 5.77%. Three cases of maternal deaths – two of which were related to PPH – were reported during the study period, which means there was a decline of 70% compared with the previous two years.
Conclusion: The prevalence of PPH has been estimated to be 5.77%; PPH represents the cause of 67% of all maternal deaths. The extension of AMTSL practice, combined with the assurance of better supplies of oxytocin to enhance drug management, is strongly advised/suggested. As a number of births still take place outside the health maternity wards, the introduction of oral misoprostol could be considered a part of AMTSL for use by patients being treated by traditional midwives.
How to cite this article: Fina Lubaki J-P, Musiti Ngolo J-R, Zikudieka Maniati L. Active management of third stage of labour, post–partum haemorrhage and maternal death rate in the Vanga Health Zone, Province of Bandundu, Democratic Republic of the Congo. Afr J Prm Health Care Fam Med. 2010;2(1), Art. #76,3 pages. DOI: 10.4102/phcfm.v2i1.76
References
AbouZahr C. Global burden of maternal death and disability. British Medical Bulletin. 2003;67:1–11.
World Health Organization. Maternal Mortality: A Global Factbook. Geneva: WHO; 1991.
Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PFA. WHO analysis of causes of maternal death: A systematic review. Lancet. 2006;367:1066−1074.
Zone de santé rurale de Vanga. Rapport annuel 2006. Vanga: ZSV; 2007.
Zone de santé rurale de Vanga. Rapport annuel 2007. Vanga: ZSV; 2008.
Prendiville WJ, Elbourne D. Care during the third stage of labor. In: Chalmers I, Enkin M, Keirse MJNC, editors. Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press, 1998; p. 1145–1169.
World Health Organization (WHO). Mother-Baby Package: Implementing Safe Motherhood in Countries. Geneva: WHO; 1998.
AbouZahr. Antepartum and post–partum haemorrhage. In: Murray CJL, Lopez AD, editors. Health dimensions of sex and reproduction: The global burden of sexually transmitted diseases, maternal conditions, perinatal disorders, and congenital anomalies. Geneva: WHO, 1998; p. 165–190.
Akins S. Postpartum haemorrhage. A 90s approach to an age-old problem. J Nurse Midwifery. 1994;39:123S−134S.
McCormick M, Sanghvi H, Kinzie B, McIntosh N. Preventing postpartum hemorrhage in low–resource settings. Int J Gynaecol Obstet. 2002;77:267–275.
FIGO ICM Joint Statement. Management of third stage of labour to prevent post-partum Haemorrhage. 2003.
WHO recommendations for the prevention of postpartum haemorrhage. Geneva: WHO; 2007.
Gülmezoglu AM et al. WHO multicentre randomised trial of misoprostol in the management of the third stage of labour. Lancet. 2001;358:689−695.
Bagley C. A comparison of active and expectant management of the third stage of labour. Midwifery. 1990;6:3–27.
Khan GQ. Controlled cord traction versus minimal interventions techniques in delivery of the placenta: A randomized controlled trial. Am J Obstet Gynecol. 1997;177:770–774.
Prendiville WJ, Elbourne D, Chalmers I. The effects of routine oxytocic administration in the management of third stage of labour: An overview of the evidence from controlled trials. Br J Obstet Gynaec. 1998;95:3–16.
Rogers J, Wood J, McCandlish et al. Active versus expectant management of third stage of labour: The Hinchingbrooke randomised controlled trial. Lancet. 1998;351:693–699.
Prendiville W, Elbourne D, McDonald S. 2003. Active versus expectant management of the third stage of labour. [Cochrane Review] In: The Cochrane Library, Issue 3, 2003. Chichester, Update Software.
Thaddeus S, Nangalia R. Perceptions Matter: Barriers to treatment of post-partum haemorrhage. J Midwifery Womens Health. 2004;49(4):293–297.
Sanghvi H, Lewison D, editors. Report of a conference in Entebbe. Preventing Mortality from post partum hemorrhage in Africa: Moving from Research to Practice; 2006 April 4−7; Entebbe, Uganda. JHPIEGO, Baltimore; 2006.
Leedy P. Practical research: planning and design. Columbus: Merrill; 1997.
Bowling A. Research methods in health: Investigating health and health services. Oxford: Oxford University Press; 2002.
Nilses C, Nyström L, Munjanja S, Lindmark G. Self-reported reproductive outcome and implications in relation to use of care in women in rural Zimbabwe. Acta Obstet Gynecol Scand. 2002;81(6):508–515.
Nwakoby BN. Use of obstetric services in rural Nigeria. J R Soc Health. 1994;114(3):132–136.
Martey JO, Djan JO, Twum S, Browne EN, Opoku SA. Maternal mortality due to post-partum haemorrhage. Int J Gynaecol Obstet. 1993;42(3):237–241.
Goldberg AB, Greenberg MA, Darney PD. Misoprostol and pregnancy. N Engl J Med. 2001;344:38–47.
Full Text: PDF (235 KB) HTML XML
