Incidence and Management of Postpartum Haemorrhage at Federal Medical Centre Asaba, Delta State

Postpartum haemorrhage (PPH) is the single leading direct cause of maternal death globally and in Nigeria, with management capacity at tertiary facilities critically determining survival outcomes. This study determines the incidence, causes, management, and outcomes of postpartum haemorrhage at the Federal Medical Centre (FMC), Asaba, Delta State, South South Nigeria. A retrospective review of all deliveries and postpartum haemorrhage cases over a three-year period from 2020 to 2022 was conducted using labour ward and theatre registers. PPH was defined as blood loss exceeding 500 ml after vaginal delivery or 1,000 ml after caesarean delivery. PPH occurred in 4.8 percent of all deliveries. Uterine atony was the most common cause (68 percent), followed by retained placenta (17 percent), genital tract lacerations (10 percent), and coagulopathy (5 percent). Active management of the third stage of labour with oxytocin was documented in 81 percent of deliveries, yet PPH incidence remained substantial, suggesting dosing and timing issues. Blood transfusion was required in 54 percent of PPH cases. Surgical interventions including B-Lynch suture and hysterectomy were performed in 12 percent. Two maternal deaths were directly attributed to PPH. Recommendations include active third-stage protocol standardisation, uterotonic availability audits, PPH simulation drills for obstetric teams, and blood bank service enhancement at FMC Asaba. Keywords: postpartum haemorrhage, maternal mortality, uterine atony, FMC Asaba, Delta State