Assessing the current practice among doctors toward managing postpartum hemorrhage in Khartoum state 2018

Rayan Adam Mahdi*

Abstract

Worldwide sever postpartum hemorrhage is a leading cause of maternal mortality and morbidity, in Sub-Saharan-Africa (SSA), where more than 50% of maternal deaths occurred and where the lifetime risk of maternal death is 10 times higher than that in high-income countries. Variations in practice, substandard managements and inadequate adherence to guidelines can lead to adverse maternity outcomes following PPH. A self-administered closed-ended questionnaire was applied to 142 physicians at three hospitals, inquiring about which practice recommended in the management of PPH described in 2 validated case- scenarios of PPH. Scenario-1 described a minor PPH and scenario-2 a major PPH. Data collected on doctors’ demographics, satisfaction, and practices regarding communication with all relevant professionals, resuscitation, monitoring and investigation and measures to arrest the bleeding. Practices’ frequencies were calculated, bivariate analysis was established to rule out significant association between each practice and hospital name and then qualification. Ordinal logistic regression also was performed. 94.4% of the doctors stated that they always call for help in case of major PPH only 2.1% they aren’t at all do that. Giving O2 by mask at 10 -15 L/ min is always administered by 41% of doctors, when we applied Chi-square we found significant differences between O2 administration and hospital type (with Chi square value=11.636 and p-value=0.02). More than 78% of doctors always practice bimanual uterine compression and oxytocin administration. This study demonstrated variations in PPH management between doctors in the same hospital and between the three hospitals understudy it also demonstrated moderate to inadequate management. oduction & Objective: Sudan is considered the 5th country among 29 countries in Africa and the middle east that still believe in Female Genital Mutilation (FGM) with prevalence of 88% according to the UNICEF in 2013. FGM is deeply fixed in the cultural and religious beliefs and widely performed among the young females in Sudan despite its commonly known complications. The objective of the study is to assess the knowledge, attitude and practice of Al Undub Abo-kleio native villagers toward the FGM performance, stigma of not doing it and the willingness to stop it in the future. Method: Community based cross-sectional descriptive study at Al Undub Abo-kleio village on November 2018. A convenient sampling was applied and a KAP questionnaire designed by the authors with full knowledge of FGM was used. The data was analyzed using Statistical Package for Social Sciences (SPSS) to find the correlation

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