Skip to main content
Log in

Risk factors for primary postpartum haemorrhage

A case control study

  • Originals
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript


The objective of the study was to determine which background factors predispose women to primary postpartum haemorrhage (PPH) at the Obafemi Awolowo University Hospital. The study consisted of 101 women who developed PPH after a normal vaginal delivery and 107 women with normal unassisted vaginal delivery without PPH Both cases and controls were investigated for sociodemographic risk factors, medical and obstetric histories, antenatal events and labour and delivery outcomes. Data were abstracted from the medical and delivery records and risks were estimated by multivariate logistic regression. The results of the unvariate analysis revealed a number of potential risk factors for PPH but after adjustment by logistic regression three factors remained significant. These were prolonged second and third stages of labour and non-use of oxytocics after vaginal delivery. Previously hypothesised risk factors for PPH such as grand multiparity, primigravidity and previous episodes of PPH were not significantly associated with PPH. We conclude that primary PPH in this population is mostly associated with prolonged second and third stages of labour and non use of oxytocics. Efforts to reduce the incidence of PPH should not only be directed at proper management of labour but also training and retraining of primary health care workers and alternative health care providers in the early referral of patients with prolonged labour.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Adetoro OO (1987) Maternal mortality: A twelve year review at the University of Ilorin, Nigeria, Int J Gynaecol Obstet 25:93–99

    Article  PubMed  CAS  Google Scholar 

  2. Adetoro OO (1989) Cervical laceration in labour: an avoidable obstetric accident. Trop J Obstet Gynaecol 7:17–18

    Google Scholar 

  3. Allen DG, Correy JF, Marsden DE (1988) Primary postpartum haemorrhage in Tasmania 1982–1986. Aust NZ J Obstet Gynaecol 28:279–283

    CAS  Google Scholar 

  4. Chukwudebelu OO (1987) Maternal mortality: A twelve year review at the University of Ilorin, Nigeria, Int J Gynaecol Obstet 25:93–99

    Article  Google Scholar 

  5. Combs CA, Murphy EL, Laros RK (1991) Factors associated with postpartum haemorrhage with vaginal birth. Obstet Gynaecol 77:69–76

    CAS  Google Scholar 

  6. Federal Office of Statistics (1992) Nigeria Demographic and Health Survey 1990. DHS IRD/Macro International, Inc

  7. Gilbert L, Porter W, Brown VA (1987) Postpartum haemorrhage—A continuing problem. Br J Obstet Gynaecol 94:67–71

    PubMed  CAS  Google Scholar 

  8. Hall MH, Halliwell R, Carr-Hill R (1985) Concomitant and repeated happenings of complications of the third stage of labour. Br J Obstet Gynaecol 92:732–738

    PubMed  CAS  Google Scholar 

  9. Harrison K (1985) Survey of 22,774 consecutive hospital births in Zaria, northern Nigeria. Br J Obstet Gynaecol 5: (Suppl) 3–118

    Google Scholar 

  10. Lennox CE (1984) Assessment of obstetric high risk factors in a developing country. Trop Doctor 14:125–129

    CAS  Google Scholar 

  11. O’Connor TC, Cavanagh D (1982) Postpartum emergencies. In: Cavanagh D (ed) Obstetric Emergencies, 3rd edn. Harper & Row. Philadelphia, pp 292–293

    Google Scholar 

  12. Okonofua FE, Abejide A, Makanjuola RA (1992) Maternal mortality in Ile-Ife, Nigeria: A study of risk factors. Studies in Family Planning 23:319–324

    Article  PubMed  CAS  Google Scholar 

  13. Royston E, Armstrong S (eds) (1989) Preventing maternal deaths. World Health Organization, Geneva, p 30

    Google Scholar 

  14. Tsu VD (1993) Postpartum haemoarrhage in Zimbabwe: A risk factor analysis. Br J Obstet Gynaecol 100:327–333

    PubMed  CAS  Google Scholar 

  15. World Health Organization (WHO) (1990) The prevention and management of postpartum haemoorhage. Report of a Technical Working Group, WHO/MCH/90.7, Geneva

    Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Cite this article

Selo-Ojeme, D.O., Okonofua, F.E. Risk factors for primary postpartum haemorrhage. Arch Gynecol Obstet 259, 179–187 (1997).

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI:

Key words