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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
3293.0: Monday, December 12, 2005 - 2:47 PM

Abstract #116473

How well can we predict postpartum hemorrhage? Insights from Egyptian data

Ndola Prata, MD, MSc1, Farnaz Vahidnia, MD, MPH2, Reginald Gipson3, Sabry Hamza, MD3, and Amr Fathy, MD3. (1) Bixby Population Program, University of California, Berkeley, 1213 Tolman Hall, UC-Berkeley, Berkeley, CA 94720, (2) Bixby Program in Family Planning, Maternal Health, and Reproductive Health, University of California at Berkeley, 1213 Tolman Hall, Berkeley, CA 94720-1690, 510-643-4284, fvahid@uclink.berkelely.edu, (3) Healthy Mother / Healthy Child, John Snow, Inc., 21 MISR Helwan Agricultural Rd., 10th floor, Maadi, Cairo, Egypt

The purpose of this paper is to determine how well can we predict primary postpartum hemorrhage in Egypt. According to the 2000 National Maternal Mortality Study in Egypt, hemorrhage was the leading contributor to maternal mortality. It was associated with 48% of direct obstetric deaths and 38% of all deaths. Primary postpartum hemorrhage (PPH) alone was responsible for 27% of all maternal deaths, making it the single most important cause of maternal death. We use data from a hospital-based Operations Research (OR) study in Egypt conducted in 2004, that provided important information to assist the Egyptian MoHP in the revision of current policies on the active management of the third stage of labor. Using logistic regression, we analyze socio-demographic; medical and past obstetric histories; use of antenatal care; and labor and delivery outcomes as potential PPH risk factors, for 2577 women. Postpartum blood loss was measured every 20 minutes for the first 4 hours after delivery, using a calibrated under the buttocks drape. The study will exploit the panel nature of the data. Because the data are repeated observations of the same individuals, we will be able to draw inference on the sequence of events leading to different outcomes. The detailed time resolution of the panel (observations every 20 minutes) will permit very time- and sequence-specific hypothesis testing. Knowledge on how well we can predict primary PPH will help policy makers and health providers redesign current delivery protocols and PPH case management.

Learning Objectives:

Keywords: Maternal Health, Maternal Morbidity

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

Evidence Based Interventions in International MCH

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA