Application of departmental management protocol for treating antepartum haemorrhage at UNIMEDTH, Akure: A 5 year overview

Preamble: This study examined the management protocol of antepartum haemorrhage and the outcome among pregnant women in University of Medical Sciences Teaching Hospital, Akure Complex. To achieve the purpose of the study, five objectives, five research questions and two corresponding null hypothesis were formulated to guide the study. Literature was reviewed under conceptual framework, theoretical framework, empirical studies and summary of literature. Some terms were conceptualized like, antepartum hemorrhage, causes of antepartum hemorrhage, predisposing factors and management guidelines for antepartum hemorrhage. Some theories related to the study were reviewed and the study was predicated on a combination of three theories namely, theory of reason action, health action process approach and three delays model.Methodology: A descriptive retrospective hospital-based design was employed for the study. The population for the study was all patients managed for antepartum haemorrhage over a period of 5 years from 2018-2022. Two hundred and seven patients out of 9,890 deliveries had Antepartum haemorrhage at the University of Medical Sciences Teaching Hospital, Akure Complex for the period under review. The instrument for data collection was a researcher developed proforma consisting of six sections. In order to determine the reliability of the instrument, Cronbach’s Alpha method of reliability was adopted. The over-all reliability co-efficient of 0.83 was obtained, which was deemed high enough to make the instrument reliable. The researcher extracted the required information/data form the hospital records, case notes and theatre registers of the hospital kept from 2018-2022. Data were analyzed using descriptive and inferential statistics and the null hypotheses were tested at 0.05 level of significance.Results: The study found among others, prevalence of antepartum hemorrhage among pregnant women in a specific location to be 2.1%. The management protocol of antepartum hemorrhage patients at UNIMEDTH was evaluated, and the overall standard of implementation was considered satisfactory. Placenta previa was the most common cause, and effective management strategies were employed, including blood transfusions and electronic fetal monitoring. A significant association was found between obstetrics history and antepartum hemorrhage, and a significant relationship was also found between management protocol and outcome of management among pregnant women.Conclusion: Antepartum haemorrhage is an important obstetric emergency that contributes significantly to maternal morbidity and mortality. It is imperative for standard well spelt out management protocols of antepartum haemorrhage to exist in every hospital in order to improve the outcomes of management. Reducing the rate of caesarean section will lead to reduction in incidences of antepartum haemorrhage.Word count: 456 words.Declaration of Interest: No any conflict of interest on the part of the researcher