TABLE OF CONTENTS
ABSTACT.......................................................................................................................................i
DECLARATION..........................................................................................................................iii
APPROVAL .................................................................................................................................iv
ACKNOWLEDGEMENT............................................................................................................ v
TABLE OF CONTENTS............................................................................................................. vi
LIST OF TABLES ........................................................................................................................ x
LIST OF FIGURES ..................................................................................................................... xi
DEFINITIONS OF KEY TERMS.............................................................................................xii
LIST OF ABREVIATIONS ......................................................................................................xiii
CHAPTER ONE ........................................................................................................................... 1
1.0 INTRODUCTION................................................................................................................. 1
1.1 BACKGROUND................................................................................................................... 1
1.2 STATEMENT OF THE PROBLEM ..................................................................................... 2
1.3 PURPOSE OF THE STUDY ................................................................................................. 3
1.4 SPECIFIC OBJECTIVES...................................................................................................... 3
1.4 RESEARCH QUESTONS..................................................................................................... 4
1.5 JUSTIFICATION OF THE STUDY...................................................................................... 4
CHAPTER TWO: LITERATURE REVIEW............................................................................ 5
2.0 INTRODUCTION................................................................................................................. 5
vii
2.1 MATERNAL RELATED FACTORS CONTRIBUTING TO PPH ...................................... 5
2.1.1. Socio-demographic Characteristics of the Study Population. ....................................... 5
2.1.2 Socio – obstetrics Characteristics. .................................................................................. 6
2.2.3 Causes of PPH due to uterine over distension ................................................................ 7
2.2.4 Labor and Child Birth..................................................................................................... 7
2.2.6 Clinical (Medical, Surgical and Gynecological) Characteristics.................................... 8
2.3 HEALTH WORKERS RELATED FACTORS THAT CONTRIBUTE TO PPH. ................ 9
2.3.1 Qualification of the birth attendant................................................................................. 9
CHAPTER THREE: METHODOLOGY................................................................................. 11
3.0 INTRODUCTION. ............................................................................................................. 11
3.2 STUDY DESIGN & RATIONALE. .................................................................................. 11
3.3 STUDY SETTING AND RATIONALE............................................................................ 11
3.4 STUDY POPULATION. ................................................................................................... 12
3.4.1 SAMPLE SIZE DETERMINATION.............................................................................. 12
3.4.2 SAMPLING PROCEDURE............................................................................................ 13
3.4.3 Inclusion criteria. .......................................................................................................... 14
3.4.4 Exclusion criteria. ....................................................................................................... 14
3.5 STUDY VARIABLES......................................................................................................... 14
3.5.1 Dependent variables...................................................................................................... 14
3.5.2 Independent variables................................................................................................. 14
3.6 RESEARCH INSTRUMENTS............................................................................................ 15
3.7 DATA COLLECTION PROCEDURE. ............................................................................. 15
viii
3.7.1 DATA MANAGEMENT. ........................................................................................................ 15
3.7.2 DATA ANALYSIS............................................................................................................... 15
3.8 ETHICAL CONSIDERATIONS ....................................................................................... 16
5.6 LIMITATIONS OF THE STUDY ............................................................................................ 16
3.10 DISSEMINATION OF RESULTS.................................................................................... 17
CHAPTER FOUR: RESULTS .................................................................................................. 18
4.0 INTRODUCTION ..................................................................................................................... 18
4.1 MATERNAL DEMOGRAPHIC CHARACTERISTICS. .................................................................... 18
4.2 MATERNAL RELATED FACTORS CONTRIBUTING TO PPH. ...................................................... 20
4.3 PREVALENCE OF POSTPARTUM HAEMORRHAGE .................................................................... 26
4.4 HEALTH WORKERS RELATED FACTORS CONTRIBUTING TO POSTPARTUM
HAEMORRHAGE. ......................................................................................................................... 27
CHAPTER FIVE: DISCUSSION.............................................................................................. 29
5.0 INTRODUCTION ..................................................................................................................... 29
5.1 PREVALENCE ........................................................................................................................ 29
5.1.1 MATERNAL DEMOGRAPHIC CHARACTERISTICS .................................................................. 29
5.1.2 MATERNAL RELATED FACTORS CONTRIBUTING TO PPH.................................................... 31
5.1.3 HEALTH WORKERS’ RELATED FACTORS CONTRIBUTING TO PPH ....................................... 33
5.2 CONCLUSIONS....................................................................................................................... 34
5.3 RECOMMENDATIONS............................................................................................................. 35
5.4 IMPLICATION ON THE NURSING PRACTICE ............................................................................. 35
ABSTRACT Statement of the problem: Postpartum haemorrhage is the World’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. In Uganda PPH accounts for 25% of maternal death related to PPH. Purpose of the study: To assess the factors contributing to Postpartum Haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University, Teaching Hospital (KIU-TH). Study design and rationale: This study used a cross-sectional descriptive designed where by a cross-section of respondents involving 68 respondents were sampled to represent the target population in these case women who receive maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and Health Workers. A cross sectional study is the one that is carried out at one point in a time or over a short period of time. Results: During the study period 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Conclusion: Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony
