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This research was conducted to study all the causes leading to postpartum hemorrhage in order to implement all the appropriate treatments, according to all reason and thus avoiding the complications of postpartum hemorrhage and death, and study of th e risk of bleeding factors in order to reach the best method of prevention of bleeding . This research included on 77 patient acceptable in Al Assad University Hospital in Lattakia, with primary postpartum hemorrhage occurred after vaginal delivery, including (12) patient after vaginal birth outside the hospital, during the extended study period: from 1/1/2014 until 1/1 / 2016, and excluded all patients who were born cesarean delivery. We determine the percentage of postpartum hemorrhage occurring between vaginal deliveries in the hospital, and the ratio was (3.52%), and we could not determine this percentage outside the hospital.
The bleeding after delivery (Postpartum Hemorrhage-PPH) is the most important complications that occur after a natural or cesarean delivery, and represents about a quarter of maternal mortality around the world. Midwives play a basis role in preventi on of bleeding after birth. So This research aims to evaluate the knowledge of midwives about using strategies to prevention and management the bleeding after delivery. Its sample included all midwives in obstetrics departments in Alasad University, Children and Obstetric, and Tishreen University Hospital all in Lattakia city. Data were collected using a questionnaire developed by researcher. The results according to strategies used in prevention and management of bleeding after delivery showed that 60% of the level of knowledge of midwives were "inappropriate". There were significant inverse relationship (P = 0.006) between ages of midwives and level of knowledge. Also showed a significant inverse relationship between number of years of experience with the midwives and level of knowledge (P = 0.01). So we suggest conducting training sessions and educational lectures for midwives with respect to the strategies used in prevention and management of bleeding after delivery, and must evaluate the midwives information about prevention and management of bleeding after delivery periodically and continuously.
Postpartum Hemorrhage (PPH) is the leading cause of maternal death worldwide. In the developing countries, it is responsible for the death of about 125 000 women each year. In most cases 67-80% are caused by uterine atony. Uterine massage would re present a simple intervention with the potential to have a major effect on PPH and maternal mortality in under resourced settings. Aim: The aim of the present study is to study the effect of uterine massage on the immediate postpartum hemorrhage among primiparae. Materials and Methods: The study was conducted of al-Assad Hospital and Children & Obstetrics Hospital (Lattakia), a convent sample of 40 primiparae women. Checklist application form was used to assess the postpartum hemorrhage by hemoglobin and hematocrit measurement before applying uterine massage and after the end of procedure. Results: This study demonstrated that the rate of hemorrhage decreased in the experimental group, hemoglobin and hematocrit was higher (10.4 mg/dl, 32.3%) (P=0.029*) (P=0.015*) among primipara who received uterine massage. Conclusions and Recommendations: Our present study results advice to apply uterine massage for all women after labor and delivery because its effective in reducing blood loss. It is also recommended to learn nurses how to apply uterine massage.
Placenta accreta is one of the most serious uncommon causes of postpartum hemorrhage which carries high morbidity and mortality risk for mother and fetus. Objective 1- to assess the incidence of placenta accreta . 2- to ideNtify The occurrence o f risk factors of placenta accreta : maternal age , multiparity , placenta praevia, previous cesarean section and/or previous curettage . 3- to find the ideal management of placenta accreta to reduce the risk of maternal and neonatal morbidity and mortality .
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