The Frequency of Primary Post-Partum Hemorrhage in Patients with Eclampsia Receiving Injection Magnesium Sulphate during Labour: A Cross Sectional Study

Background: Eclampsia remains a leading cause of maternal morbidity and mortality, particularly in low- and middle-income countries. While magnesium sulfate (MgSO₄) is the standard treatment for seizure prophylaxis, concerns persist regarding its potential association with postpartum hemorrhage (PPH). Objective: To determine the frequency of primary PPH in women with eclampsia receiving MgSO₄ and to evaluate its association with maternal characteristics, labor variables, and outcomes. Methods: A cross-sectional study was conducted on 83 women diagnosed with eclampsia. Demographic, clinical, and labor-related data were recorded, and PPH was defined according to WHO criteria. Associations between PPH and study variables were analyzed using chi-square tests with Cramer’s V for strength of association. Results: Primary PPH occurred in 25.3% of women, predominantly due to uterine atony (61.9%) within the first hour after delivery. Strong associations were found between PPH occurrence and both its type and onset (Cramer’s V = 1.000, p < 0.001). PPH was significantly associated with blood transfusion requirements (Cramer’s V = 0.706, p < 0.001), but not with age, parity, gestational age, severity of eclampsia, blood pressure, proteinuria, or delivery mode. No maternal deaths or ICU admissions were attributed to PPH. Conclusion: In eclamptic women receiving MgSO₄, PPH was primarily atonic and early onset, with blood transfusion frequently required. MgSO₄ use did not independently increase PPH risk, supporting its continued role in eclampsia management. Strengthening active third-stage labor management and PPH preparedness may further reduce morbidity.