Postpartum Hemorrhage in a Conflict Setting

Chapter

Abstract

Mapendo is a 24-year-old woman who has just given birth to her fifth child after a 3-day labor. It is the middle of the night and although quite dark, the birth attendant can tell there has been too much bleeding.

Keywords

Placebo Fatigue Transportation Anemia Diarrhea 

References

  1. Alfirevic Z, Blum J, Walraven G, Weeks A, Winikoff B. Prevention of postpartum haemorrhage with misoprostol. Int J Gynecol Obstet. 2007;99 Suppl 2:198–201.CrossRefGoogle Scholar
  2. Allen R, O’Brien B. Uses of misoprostol in obstetrics and gynecology. Rev Obstet Gynecol. 2009;2(3):159–68.PubMedGoogle Scholar
  3. Anderson L. TRUSTLAW POLL—Afghanistan is most dangerous country for women. 2011. http://www.trust.org/trustlaw/news/trustlaw-poll-afghanistan-is-most-dangerous-country-for-women/.
  4. Anderson JM, Etches D. Prevention and management of postpartum hemorrhage. Am Fam Physician. 2007;75(6):875–82. http://www.aafp.org/afp/2007/0315/p875.html.PubMedGoogle Scholar
  5. Andreatta P, Gans-Larty F, Deboupr D, et al. Evaluation of simulation-based training on the ability of birth attendants to correctly perform bimanual compression as obstetric first aid. Int J Nurs Stud. 2011;48(10):1275–80.PubMedCrossRefGoogle Scholar
  6. Brennan R, Coghlan B, Hardy C, Lewis J, Ngoy P, Nkamgang Bemo V, et al. Mortality in the Democratic Republic of Congo: an ongoing crisis. http://www.rescue.org/sites/default/files/migrated/resources/2007/2006-7_congomortalitysurvey.pdf.
  7. Casey S, Mitchell K, Mulamba Amisi I, Migombano Haliza M, Aveledi B, Kalenga P, et al. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo. Confl Health. 2009;3:12. Published Online 2009 December 21. doi:  10.1186/1752-1505-3-12. PMCID: PMC2809040.PubMedCrossRefGoogle Scholar
  8. Demographic and Health Surveys project (MEASURE DHS). Democratic Republic of the Congo, Demographic and Health Survey 2007, Key Findings. Calverton, MD: Macro International, Inc. Available at: http://www.measuredhs.com/pubs/pdf/SR141/SR141.pdf. Accessed 9/17/2012.
  9. Derman RJ, Kodkany BS, Goudar SS, et al. Oral Misoprostol in preventing postpartum haemorrhage in resource- poor communities: a randomized controlled trial. Lancet. 2006;368:1248–53.PubMedCrossRefGoogle Scholar
  10. Devine PC. Obstetric hemorrhage. Semin Perinatol. 2009;33(2):76–81.PubMedCrossRefGoogle Scholar
  11. Dildy III GA. Postpartum hemorrhage: new management options. Clin Obstet Gynecol. 2002;45(2):330–44. Review.PubMedCrossRefGoogle Scholar
  12. Dolea C, AbouZahr C, Stein C. Global burden of maternal haemorrhage in the year 2000. WHO. 2003. http://www.who.int/healthinfo/statistics/bod_maternalhaemorrhage.pdf
  13. Family Care International. Mapping misoprostol for postpartum hemorrhage: organizational activities, challenges, and opportunities. FCI. 2011. http://familycareintl.org/UserFiles/File/Mapping_FINAL_SM.pdf
  14. Geller SE, Adams MG, Kelly PJ, Kodkany BS, Derman RJ. Postpartum hemorrhage in resource-poor settings. Int J Gynaecol Obstet. 2006;92(3):202–11. Epub 2006 Jan 19. Review.PubMedCrossRefGoogle Scholar
  15. Goldberg AB, Greenberg MA, Darney PD. Misoprostol and pregnancy. N Engl J Med. 2001;344(1):38–47.Google Scholar
  16. Haeri S, Dildy III GA. Maternal mortality from hemorrhage. Semin Perinatol. 2012;36(1):48–55.PubMedCrossRefGoogle Scholar
  17. Hoj L, Cardoso P, Nielson BB, Hvidman L, Nielsen J, Aaby P. Effect of sublingual misoprostol on severe postpartum hemorrhage in a primary health center in Guinea-Bissau: randomized double blind clinical trial. Br Med J. 2005;331:723–7.CrossRefGoogle Scholar
  18. International Confederation of Midwives and International Federation for Gynecology and Obstetrics. Prevention and treatment of post-partum hemorrhage: new advances for low resource settings. Int J Gynecol Obstet. 2007;97(2):160–3.CrossRefGoogle Scholar
  19. Jokhio AH, Winter HR, Cheng KK. An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan. N Engl J Med. 2005;352(20):2091–9.PubMedCrossRefGoogle Scholar
  20. Kabali E, Gourbin C, De Brouwere V. Complications of childbirth and maternal deaths in Kinshasa hospitals: testimonies from women and their families. BMC Pregnancy Childbirth. 2011;11:29.PubMedCrossRefGoogle Scholar
  21. Khalafallah AA, Dennis AE. Iron deficiency anaemia in pregnancy and postpartum: pathophysiology and effect of oral versus intravenous iron therapy. J Pregnancy. 2012;2012:630519. Epub 2012 Jun 26.PubMedGoogle Scholar
  22. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066–74.PubMedCrossRefGoogle Scholar
  23. Lalonde A. Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynecol Obstet. 2012;117(2):108–18. ISSN 0020–7292,  10.1016/j.ijgo.2012.03.001.CrossRefGoogle Scholar
  24. Lindahl C. Misoprostol added to WHO list of essential medicines for PPH. Maternal Health Task Force. 2011. http://www.who.int/pmnch/media/blogs/20110519_misoprostol/en/index.html
  25. Longombe AO, Claude KM, Ruminjo J. Fistula and traumatic genital injury from sexual violence in a conflict setting in Eastern Congo: case studies. Reprod Health Matters. 2008;16(31):132–41.PubMedCrossRefGoogle Scholar
  26. Lumbiganon P, Hofmeyr J, Gulmezoglu AM, Pinol A, Villar J. Misoprostol dose-related shivering and pyrexia in the third stage of labour. WHO collaborative trial of misoprostol in the management of the third stage of labour. Br J Obstet Gynaecol. 1999;106:304–8.PubMedCrossRefGoogle Scholar
  27. Magann EF, Evans S, Chauhan SP, Lanneau G, Fisk AD, Morrison JC. The length of the third stage of labor and the risk of postpartum hemorrhage. Obstet Gynecol. 2005;105(2):290–3.PubMedCrossRefGoogle Scholar
  28. Making childbirth safer, use of oxytocin in the Uniject™ injection system to prevent severe bleeding. http://www.path.org/projects/uniject-oxytocin.php
  29. Mangiaterra V, Pendse R, McClure K, Rosen J. Adolescent pregnancy. MPS Notes. 2008;1(1). WHO. http://www.who.int/maternal_child_adolescent/documents/mpsnnotes_2_lr.pdf
  30. Matendo R, Engmann C, Ditekemena J, Gado J, Tshefu A, Kinoshita R, et al. Reduced perinatal mortality following enhanced training of birth attendants in the Democratic Republic of Congo: a time-dependent effect. BMC Med. 2011;9:93.PubMedCrossRefGoogle Scholar
  31. McCormick ML, Sanghvi HC, Kinzie B, McIntosh N. Preventing postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet. 2002;77(3):267–75.PubMedCrossRefGoogle Scholar
  32. Miller PC, Rashida G, Tasneem Z, Haque M. The effect of traditional birth attendant training on maternal and neonatal care. Int J Gynaecol Obstet. 2012;117(2):148–52.PubMedCrossRefGoogle Scholar
  33. Mukuria A, Aboulafia C, Themme A. The context of women’s health: results from the Demographic and Health Surveys, 1994–2001. Calverton, MD: ORC Macro; 2005. http://www.measuredhs.com/pubs/pdf/CR11/CR11.pdf.Google Scholar
  34. Oyelese Y, Ananth CV. Postpartum hemorrhage: epidemiology, risk factors, and causes. Clin Obstet Gynecol. 2010;53(1):147–56.PubMedCrossRefGoogle Scholar
  35. Peterman A, Palermo T, Bredenkamp C. Estimates and determinants of sexual violence against women in the Democratic Republic of Congo. Am J Public Health. 2011;101(6):1060–7. http://www2.carleton.ca/africanstudies/ccms/wp-content/ccms-files/AJPH-Sexual-Violence-DRC.pdf.PubMedCrossRefGoogle Scholar
  36. POPPHI (USAID’s Prevention of Postpartum Hemorrhage Initiative). Active management of the third stage of labor. Data obtained from national health network hospitals in Guatemala: July to August 2006. http://www.pphprevention.org/files/Guatemalafinalreport.pdf
  37. Prata N, Mbaruku G, Grossman A, Holston M, Hsieh K. Community-based availability of misoprostol: is it safe? Afr J Reprod Health. 2009;13:117–28.PubMedGoogle Scholar
  38. Prendville WJ, Elbourned D, McDonald S. Active versus expectant management in the third stage of labor. Cochrane Database Syst Rev. 2000;3:CD000007.Google Scholar
  39. Rizvi F, Mackey R, Barrett T, McKenna P, Geary M. Successful reduction of massive postpartum haemorrhage by use of guidelines and staff education. BJOG. 2004;111(5):495–8. Erratum in: BJOG. 2007 May;114(5):660.PubMedCrossRefGoogle Scholar
  40. Rogers J, Wood J, McCandlish R, Ayers S, Truesdale A, Elbourne D. Active versus expectant management of third stage of labour: the Hinchingbrooke randomized controlled trial. Lancet. 1998;351(9104):693–9.PubMedCrossRefGoogle Scholar
  41. Rossi L, Hoerz T, Thouvenot V, Pastore G, Michael M. Evaluation of health, nutrition and food security programmes in a complex emergency: the case of Congo as an example of a chronic post-conflict situation. Public Health Nutr. 2006;9(5):551–6.PubMedCrossRefGoogle Scholar
  42. Sanghvi H, Ansari N, Prata N, Gibson H, Aftab E, Smith J. Prevention of postpartum hemorrhage at home birth in Afghanistan. Int J Gynecol Obstet. 2010;108:276–81.CrossRefGoogle Scholar
  43. Save the Children. Nutrition in the first 1,000 days. State of the world’s mothers 2012. 2012. http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/STATEOFTHEWORLDSMOTHERSREPORT2012.PDF.
  44. Spiegel PB, Checchi F, Colombo S, Paik E. Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet. 2010;375(9711):341–5.PubMedCrossRefGoogle Scholar
  45. Tsu VD, Langer A, Aldrich T. Postpartum hemorrhage in developing countries: is the public health community using the right tools? Int J Gynaecol Obstet. 2004 Jun;85 Suppl 1:S42–51.Google Scholar
  46. United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), World Health Organization (WHO), World Bank. Trends in maternal mortality: 1990 to 2010. WHO. 2012. http://www.unfpa.org/public/home/publications/pid/10728
  47. Van Herp M, Parqué V, Rackley E, Ford N. Mortality, violence and lack of access to healthcare in the Democratic Republic of Congo. Disasters. 2003;27(2):141–53.PubMedCrossRefGoogle Scholar
  48. Wakabi W. The Democratic Republic of the Congo in crisis. Lancet. 2008;372(9655):2011–2.PubMedCrossRefGoogle Scholar
  49. Walraven G, Blum J, Dampha Y, Sowe M, Morison L, Winikoff B. Misoprostol in the management of the third stage of labour in the home delivery setting in rural Gambia: a randomized controlled trial. Br J Obstet Gynaecol. 2005;112:1277–83.CrossRefGoogle Scholar
  50. WHO, UNICEF. Countdown to 2015: maternal, newborn and child survival. Building a future for women and children: the 2012 report. WHO and UNICEF. 2012. http://www.countdown2015mnch.org/documents/2012Report/2012-Complete.pdf
  51. WHO, UNFPA, UNICEF, World Bank. Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Geneva: WHO; 2000. http://whqlibdoc.who.int/publications/2007/9241545879_eng.pdf.Google Scholar
  52. Winikoff B, Dabash R, Durocher J, et al. Treatment of postpartum haemorrhage with sublingual misoprostol versus oxytocin in women not exposed to oxytocin during labour: a double-blind, randomized, non-inferiority trial. Lancet. 2010;375:210–6.PubMedCrossRefGoogle Scholar
  53. WHO. Maternal mortality fact sheet no. 348. 2012. http://www.who.int/mediacentre/factsheets/fs348/en/index.html.
  54. WHO. The world health report 2005. Make every mother and child count. Chapter 4: attending to 136 million births, every year. WHO. 2005. http://www.who.int/whr/2005/chapter4/en/index1.html.
  55. WHO. WHO guidelines for the management of postpartum haemorrhage and retained placenta. WHO. 2009. http://whqlibdoc.who.int/publications/2009/9789241598514_eng.pdf

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.School of MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.Maimonides Medical Center, BrooklynNew YorkUSA
  3. 3.Division of Global Health, Department of Obstetrics, Gynecology and Reproductive ScienceIcahn School of Medicine at Mount SinaiNew YorkUSA

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