Early post-partum hemorrhage after spontaneous vaginal delivery: prevention and management done by midwives at butare university teaching hospital

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Background: Postpartum hemorrhage (PPH) is the leading cause of maternal death in low-income countries and is the primary cause of approximately one-quarter of global maternal deaths. The purpose of this paper is to assess the prevention and management of early postpartum hemorrhage (PPH) after spontaneous vaginal delivery at Butare University Teaching Hospital. Methods: Quantitative prospective observational study, 31 women in labor from the end of the second stage of labor to the end of early postpartum after spontaneous vaginal delivery during data collection period (From March 20th to April 2, 2015). The participant involved in this Evidence Based Practice was observed after getting and signing consent form. Patient’s files, data correction form was used to correct data. All processes were done after getting approval from ethical committee and Butare University Teaching Hospital research committee permission to conduct the project. The data were entered in SPSS version 16 for being analyzed; Microsoft word for text elaboration and Microsoft excel was used for making tables. Results: Active management of the third stage of labor is considered the “gold standard” strategy for reducing the incidence of PPH. It combines nondrug interventions (controlled cord trac­tion and cord clamping) with the administration of an uterotonics drug, Unfortunately, Oxytocin is used in majority of cases(93.5%:n=29) followed by uterine massage (67,7%:n=21), but the controlled cord traction is the last one with (54,8%:n=17).For management vital signs are taken at 100% (n=6),estimated blood loss done at 66.7% (n=4) differently, establish intravenous access and prevention of shock are done at (83.3%: n=5). Transfusion done at 50% (n=3) and catheterized bladder not done at 83.3% (n=5). Conclusion: As the main cause of maternal mortality worldwide, PPH prevention interventions need to be prioritized. Increased access to prophylactic uterotonics, regardless of where deliveries occur, should be the primary means of reducing the complication of PPH.