Estelle DOSSOU

ABSTRACT Immediate postpartum hemorrhage (IPH) is one of the leading causes of maternal death in developing countries and is defined as blood loss of more than 500 ml within 24 hours of delivery. It is often aggravated by delays in recognition, management and referral of patients. This study aimed to determine the prevalence, causes and management modalities of IPH at the maternity ward of Savè Zone Hospital in 2025. We conducted a retrospective descriptive study over a period of 15 months. All records of women who gave birth in the maternity ward of the zonal hospital from January 2024 to March 2025 were included in the study. A total of 30 records of women who presented with HPPI were retained. Data were collected from medical records and analyzed descriptively with R software versions 4.4.2. Qualitative variables were expressed as percentages and quantitative variables as means with their standard deviations. Out of a total of 1169 deliveries recorded during the period, 30 women had Immediate Postpartum Hemorrhage, a prevalence of 2.56%. The average age of patients with postpartum hemorrhage is 27.13 years ± 6.40 years, with extremes of 17 and 44 years. The average gestation observed in this study was 3.56 ± 2.04, with extremes ranging from 1 to 8. The average parity is 3.06 ± 2.09. The average number of prenatal consultations (CPN) carried out by the women surveyed was 3.03 with a standard deviation of 2.14. 66.67% were referred from another health facility. Uterine atony is identified as the main cause of PPH, followed by birth canal trauma. The majority of patients are successfully managed with the use of oxytocics and other medical interventions. HPPI is a major obstetric emergency and remains one of the leading causes of maternal mortality. It occurs within 24 hours of delivery and requires rapid and effective management. Its prevention relies on active management of delivery and identification of risk factors. Keywords: HPPI; prevalence, associated factors; HZ Savè

ABSTRACT The health reforms initiated in Benin in 2016 have allowed the reorganization of the practice of health professions in private clients, including nursing. To describe the socio-demographic and academic characteristics of nurses applying for authorization to open and operate Private Nursing Practices (CSIP) in Benin. A review of the applications for opening and operating CSIPs, submitted from 2021 to 2024 and selected by exhaustive probability sampling, was carried out. Linear relationships between certain variables were identified using the Pearson correlation test with the Stata/IC 16.0 statistical analysis software. 306 Beninese applicants, 72.55% of whom were men, were registered. Their average age was 38 years and 31 (10.1307%) were aged 60 and over. 53.9213% of the requested installation sites were located in Alibori, Atacora, Borgou and Donga. 76.4705% of the nursing diplomas presented were obtained between 2017 and 2022. 68.6274% of these diplomas came from abroad, including 55.2287% from Burkina Faso. In addition, 69.60% of the diplomas presented were the State Nursing Diploma, 73.70% of which were issued in Burkina Faso. Authorization was granted to 87.11% of the applicants. Applicants of retirement age in Benin raise the issue of sponsorship, the legal contours of which deserve to be clarified. The unequal distribution of installation sites requires the development of a private health map with the objective of Universal Health Coverage. The predominance of foreign diplomas implies the assessment of the skills of their holders.