ArticleBMC pregnancy and childbirth2020
Major obstetric haemorrhage in Metro East, Cape Town, South Africa: a population-based cohort study using the maternal near-miss approach.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Socioeconomic, demographic and obstetric determinants of maternal near miss in Africa: A systematic review.PloS one · 2025Pooled it
- Health system stress: Assessing the impact of the COVID-19 pandemic on obstetric haemorrhage-related mortality in South Africa using confidential enquiry into maternal deaths data.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Preparedness of emergency care providers to manage obstetric haemorrhage in KwaZulu-Natal province, South Africa: A mixed-methods study.Journal of the colleges of medicine of South Africa · 2026Article
- Knowledge, attitude and practice of emergency care providers on obstetric haemorrhage in KwaZulu-Natal, South Africa: A cross-sectional study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Two Postpartum Blood Collection Devices: The Brass-V Drape and MaternaWell Tray-As Experienced by Birth Attendants and Birthing Women-A Questionnaire-Based Randomised Study.Obstetrics and gynecology international · 2024Article
- Midwives' descriptions of avoidable causes of negative perinatal outcomes.Health SA = SA Gesondheid · 2023Article
- A synthesis of clinical and health system bottlenecks to implementing new WHO postpartum hemorrhage recommendations: Secondary data analysis of the Kenya Confidential Enquiry into Maternal Deaths 2014-2017.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Article
- Adverse Perinatal and Maternal Outcomes and Associated Factors among Women with Antepartum Hemorrhage in Jimma University Medical Center, Southwest Ethiopia, 2020.Obstetrics and gynecology international · 2022Article
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Authors and funding
8 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMajor obstetric haemorrhage is a leading cause of maternal mortality and accounts for one-third of maternal deaths in of Africa. This study aimed to assess the population-based incidence, causes, management and outcomes of major obstetric haemorrhage and risk factors associated with poor maternal outcome.
methodsWomen with major obstetric haemorrhage who met the WHO maternal near-miss criteria or died in the Metro East region, Cape Town, South Africa, were evaluated from November 2014-November 2015. Major obstetric haemorrhage was defined as haemorrhage in pregnancies of at least 20 weeks' gestation or occurring up to 42 days after birth, and leading to hysterectomy, hypovolaemic shock or blood transfusion of ≥5 units of Packed Red Blood Cells. A logistic regression model was used to analyse associations with poor outcome, defined as major obstetric haemorrhage leading to massive transfusion of ≥8 units of packed red blood cells, hysterectomy or death.
resultsThe incidence of major obstetric haemorrhage was 3/1000 births, and the incidence of massive transfusion was 4/10.000 births in the Metro East region (32.862 births occurred during the studied time period). Leading causes of haemorrhage were placental abruption 45/119 (37.8%), complications of caesarean section 29/119 (24.4%) and uterine atony 13/119 (10.9%). Therapeutic oxytocin was administered in 98/119 (82.4%) women and hysterectomy performed in 33/119 (27.7%). The median numbers of packed red blood cells and units of Fresh Frozen Plasma transfused were 6 (interquartile range 4-7) and 3 (interquartile range 2-4), ratio 1.7:1. Caesarean section was independently associated with poor maternal outcome: adjusted OR 4.01 [95% CI 1.58, 10.14].
conclusionsAssessment of major obstetric haemorrhage using the Maternal Near Miss approach revealed that placental abruption and complications of caesarean section were the major causes of major obstetric haemorrhage. Caesarean section was associated with poor outcome.
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