Retrospective Descriptive Study of Postpartum Hemorrhage at Central Sebha Hospital, Libya, 2004–2006

Abstract

Postpartum hemorrhage remains one of the most important obstetric emergencies and a major preventable contributor to maternal morbidity and mortality. This retrospective descriptive study evaluated the incidence, causes, selected risk factors, and complications of postpartum hemorrhage among women managed at Central Sebha Hospital, Libya, during 2004, 2005, and 2006. Data were extracted from hospital records for 261 cases and included maternal age, cause of hemorrhage, type of delivery, fetal birth weight, blood transfusion, complications, and pre- and post-delivery packed cell volume changes. The recorded incidence of postpartum hemorrhage increased from 1.20% in 2004 to 2.31% in 2005 and 3.49% in 2006. Uterine atony was the leading cause, accounting for 182 cases (69.7%), followed by abruptio placentae in 37 cases (14.2%), genital tract injury in 24 cases (9.2%), retained products of conception in 12 cases (4.6%), placenta previa in 4 cases (1.5%), and coagulopathy in 2 cases (0.8%). Anemia was the most frequent complication, affecting approximately 87% of cases. Hysterectomy was required in two cases, including one maternal death, and renal impairment was recorded in two cases. Packed cell volume decreased by 4–10% in 48.7% of cases and by more than 10% in 39.8%. These findings indicate that postpartum hemorrhage represented a clinically important burden during the study period and that uterine atony was the dominant cause. Strengthening active management of the third stage of labor, early recognition, quantitative blood-loss assessment, and structured response bundles may reduce preventable morbidity.