Frequency of Post-Partum Hemorrhage and Associated Factors in Primiparous Women


Wahida Ahmady
Mohammad Haroon Rahemi
Orzala Saidal
Mohammad Azim Azimee


Background: Postpartum hemorrhage refers to excessive blood loss during or after delivery, it defined as blood loss greater than or equal to 1000 ml or blood loss within 24 hours after the birth. The objective of this study is to investigate frequency of post-partum hemorrhage and associated factors in primiparous women.
Materials and Methods: A hospital based cross sectional study was conducted among 104 women aged 18-48 years, during six months (01/Oct/2022 to 30/March/2023). Women diagnosed post-partum hemorrhage and admitted in Nangarhar university teaching hospital (gestational age 36-42 weeks) were included in the study.
Findings: Among 104 women, who were observed, mean age was 25.70 ± 5.24, most affected (71.15%) age group interval was (20 to 29-year age group). About 63(60.60%) were Primiparous and (39. 40%) women were multi parous. About fourth-five (80.80%), two third (67.30%), and one -third (31.70%) of participant were, illiterate and house wives, lived in rural areas and expressed as the economic condition as poor, respectively.
Conclusion: History of pre-delivery anemia, maternal age, prolong labor, type of delivery, oxytocin use, low economic status, low education level and hypertension in pregnancy were associated factors for postpartum hemorrhage. 20-29-year age group, atony of uterus, prolonged labour, use of oxytocin, toxemia of pregnancy, and C/S delivery was statistically significant risk factors between primiparous and multiparous women. Close observation in antenatal, pre partum periods and intrapartum period is needed to identify women who have associated factors and early intervention to prevent post-partum hemorrhage.


Associated factors, Atony of uterus, Labor, Post-partum hemorrhage


How to Cite
Ahmady, W., Rahemi, M. H., Saidal, O., & Azimee, M. A. (2023). Frequency of Post-Partum Hemorrhage and Associated Factors in Primiparous Women. NUIJB, 2(04), 01–08. Retrieved from


  1. Al‐Zirqi, I., Vangen, S., Forsen, L., & Stray‐Pedersen, B. (2008). Prevalence and risk factors of severe obstetric haemorrhage. BJOG: An International Journal of Obstetrics & Gynaecology, 115(10), 1265-1272.
  2. Baskett, T. (2014). Assisted vaginal delivery. Munro Kerr's Operative Obstetrics E-Book, 88.
  3. Cunningham, F., MacDonald, C., Gant, F., Leveno, J., Gilstrap, C., Hankins, V., & Clark, L. (1997). Williams Obstetrics, 20th edit. In: Stanford: Appleton & Lange.
  4. DeCherney, A. H., Nathan, L., Laufer, N., Roman, A. S., & Education, M.-H. (2019). Current diagnosis & treatment: obstetrics & gynecology. McGraw-Hill Education.
  5. Dutta, D. (2004). Text book of obstetrics: including perinatology and contraception. New central book agency.
  6. Fukami, T., Koga, H., Goto, M., Ando, M., Matsuoka, S., Tohyama, A., Yamamoto, H., Nakamura, S., Koyanagi, T., & To, Y. (2019). Incidence and risk factors for postpartum hemorrhage among transvaginal deliveries at a tertiary perinatal medical facility in Japan. PloS one, 14(1), e0208873.
  7. Gani, G. N., & Ali, A. T. (2013). Prevalence and factors associated with maternal postpartum haemorrhage in Khyber Agency, Pakistan. Journal of Ayub Medical College Abbottabad, 25(1-2), 81-85.
  8. Halle-Ekane, G., Emade, F., Bechem, N., Palle, J., Fongaing, D., Essome, H., & Fomulu, N. (2016). Prevalence and risk factors of primary postpartum hemorrhage after vaginal deliveries in the Bonassama District Hospital, Cameroon. International Journal of Tropical Disease & Health, 13(2), 1-12.
  9. Hoestermann, C., Ogbaselassie, G., Wacker, J., & Bastert, G. (1996). Maternal mortality in the main referral hospital in The Gambia, West Africa. Tropical Medicine & International Health, 1(5), 710-717.
  10. Kebede, B. A., Abdo, R. A., Anshebo, A. A., & Gebremariam, B. M. (2019). Prevalence and predictors of primary postpartum hemorrhage: An implication for designing effective intervention at selected hospitals, Southern Ethiopia. PloS one, 14(10), e0224579.
  11. Lutomski, J. E., Byrne, B. M., Devane, D., & Greene, R. A. (2012). Increasing trends in atonic postpartum haemorrhage in Ireland: an 11‐year population‐based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 119(3), 306-314
  12. Mvandal, S., & Kindimba, C. (2021). Prevalence, Causes and associated factors for Postpartum haemorrhage (PPH) at St. Joseph referral hospital Peramiho-Songea, Tanzania; A hospital-based retrospective cross-sectional study.
  13. Shahbazi Sighaldeh, S., Nazari, A., Maasoumi, R., Kazemnejad, A., & Mazari, Z. (2020). Prevalence, related factors and maternal outcomes of primary postpartum haemorrhage in governmental hospitals in Kabul-Afghanistan. BMC pregnancy and childbirth, 20, 1-9.

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