{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:53:14Z","timestamp":1793055194496,"version":"4.5.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T00:00:00Z","timestamp":1632096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>In Gabon, the proportion of maternal deaths directly related to Primary PostPartum Haemorrhage (PPPH) is 15 to 25%, despite the different means that the World Health Organization has made available to the providers of Emergency Obstetrical and Neonatal Care (EmONC). The objective of this study was to determine the prevalence and epidemiological characteristics of Primary PostPartum Haemorrhage to improve its management and reduce the rate of maternal deaths. An analytical retrospective study involved 42,728 records, whose data were collected using a chart collection form on the basis of information contained in partograms and other patient records. Sociodemographic variables were expressed using percentage. The relationship between the etiologies of PPPH and certain characteristics of the women was established using the ORs with their 95% confidence intervals. The difference was significant if p &lt; 0.05. The prevalence of PPPH was 1.6%. Delivery haemorrhages accounted for 65.5% of PPPH. The main factors associated with delivery haemorrhages were pauci parity and multiparity (p = 0.003 and 0.051), post-term (p = 0.042), and birth weight &gt;4,000 g (p = 0.006). Those associated with genital tract injuries were young maternal age (p = 0.008) and multiparity (p = 0.028). The most common etiology was haemorrhage from delivery. Multiparity remains the most common risk factor and the young age of the patients. It is important to improve management through better assessment of blood loss in the primary postpartum period as well as capacity building of health providers on EmONC.<\/jats:p>","DOI":"10.1371\/journal.pone.0257544","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T17:39:00Z","timestamp":1632159540000},"page":"e0257544","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Primary postpartum haemorrhage at the Libreville University Hospital Centre: Epidemiological profile of women"],"prefix":"10.1371","volume":"16","author":[{"given":"Nathalie Ledaga","family":"Ambounda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4459-0597","authenticated-orcid":true,"given":"Sylvain Honore","family":"Woromogo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicite-Emma","family":"Yagata-Moussa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liela Agnes Okoyi","family":"Ossouka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky Noel Simo","family":"Tekem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliane Okira","family":"Ango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain Jepang","family":"Kouanang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"issue":"3","key":"pone.0257544.ref001","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.ijgo.2013.06.024","article-title":"New WHO recommendations on prevention and treatment of postpartum hemorrhage","volume":"123","author":"O Tun\u00e7alp","year":"2013","journal-title":"Int J Gynaecol Obstet"},{"issue":"8","key":"pone.0257544.ref002","first-page":"4S9","article-title":"Post-partum haemorrhage: frequency, consequences in terms of health status, and risk factors before delivery","volume":"33","author":"D Subtil","year":"2004","journal-title":"J Gynecol Obstet Biol Reprod"},{"issue":"1","key":"pone.0257544.ref003","first-page":"998","article-title":"Initial obstetrical management of port-partum haemorrhage following vaginal delivery","volume":"43","author":"P Dolley","year":"2014","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"pone.0257544.ref004","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/S0140-6736(06)68397-9","article-title":"WHO analysis of causes of maternel death: a systematic review","volume":"367","author":"KS Khan","year":"2006","journal-title":"Lancet"},{"issue":"2","key":"pone.0257544.ref005","first-page":"28","article-title":"Immediate postpartum haemorrhage:Epidemiological aspects and maternal prognosis at South N\u2019Djamena District Hospital (Chad)","volume":"8","author":"BM Gabkika","year":"2015","journal-title":"South Sudan Medical Journal"},{"issue":"6","key":"pone.0257544.ref006","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: a WHO systematic analysis","volume":"2","author":"L Say","year":"2014","journal-title":"Lancet Glob Health"},{"issue":"7294","key":"pone.0257544.ref007","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1136\/bmj.322.7294.1089","article-title":"Incidence and predictors of severe obstetric morbidity: case-control study","volume":"322","author":"M Waterstone","year":"2001","journal-title":"BMJ"},{"key":"pone.0257544.ref008","unstructured":"Ministry of Health\/ UNFPA. National report on maternal deaths in Gabon 2012\u20132015. [Cited on 24th March 2020]. Available on: https:\/\/www.undp.org\/content\/dam\/gabon\/docs\/Country%20team\/UNFPA-rapport%20sur%20les%20d%c3%a9c%c3%a8s%20maternels%202012-2015.pdf."},{"issue":"2","key":"pone.0257544.ref009","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/GCO.0b013e32835e1505","article-title":"Strategies to reduce maternal mortality in developed countries","volume":"25","author":"JC King","year":"2013","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"4","key":"pone.0257544.ref010","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/tmi.12065","article-title":"Preventable maternal mortality in Morocco: the role of hospitals","volume":"18","author":"S Abouchadi","year":"2013","journal-title":"Trop Med Int Health"},{"issue":"1","key":"pone.0257544.ref011","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.midw.2010.12.001","article-title":"A critical analysis of maternal morbidity and mortality in Liberia, West Africa.","volume":"28","author":"JR Lori","year":"2012","journal-title":"Midwifery"},{"issue":"10","key":"pone.0257544.ref012","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.jgyn.2014.09.023","article-title":"Epidemiology of post-partum haemorrhage","volume":"43","author":"C Deneux-Tharaux","year":"2014","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"pone.0257544.ref013","unstructured":"Ministry of Economy, Employment and Sustainable Development\/ UNDP and ICF International. Gabon Demographic and Health Survey 2012: Synthesis Report. 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Lacomme","year":"1960"},{"issue":"1","key":"pone.0257544.ref026","first-page":"S244","article-title":"Maternal morbidity after operative vaginal delivery","volume":"37","author":"G. 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