Postpartum haemorrhage was a significant contributor to obstetric haemorrhage and SMO in Nigerian hospitals. Although the timing of life-saving interventions was not statistically different between the cases of MD and MNM, close to one-quarter of women who died received critical intervention at least 4 hours after diagnosis of life-threatening PPH. MD was more likely when PPH led to neurological (80.8%), renal (73.5%) or respiratory (58.7%) organ dysfunction. About 83% of women with SMO were admitted in a critical condition with over 50% being referred. PPH had the highest maternal mortality ratio (112/100 000 live births) and the recorded MI (29.1%) and CFR (4.9%) were second only to that of ruptured uterus. It was the most frequent obstetric haemorrhagic complication across hospitals. Postpartum haemorrhage occurred in 2087 (2.2%) of the 94 835 deliveries recorded during the study period. Incidence of SMO, health service events, case fatality rate (CFR) and mortality index (MI: % of death/SMO). MethodsĪll cases of SMO due to PPH were prospectively identified using WHO criteria over a 1-year period. Women admitted for pregnancy, childbirth or puerperal complications. Secondary analysis of a nationwide cross-sectional study. To investigate the burden and health service events surrounding severe maternal outcomes (SMO) related to life-threatening postpartum haemorrhage (PPH) in Nigerian public tertiary hospitals.
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