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with imp rovements i n labour managemen t, the reported levels
now r ange between a bo u t 4 t o 8' ( 43 , 162] . There are rev
reports on the incidence »t: postpartum haemorrhage in
developing countries. In Africa, r a t e s which ha ve been
r e ported so far f r om hospital -based studie s are generally l ow,
even t hough materna l mortality figures i nd i c a t e that
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haemo r rhage and anaem ia a r e the major causes of pos t pa r t um
deat hs [120116 3) •
In the Came roon, west Africa , pos t pa r tum haem orrhag e
r ates report ed f r om one hospi t a l from 1982 -86 , r ange d from 0.4
to 2.0\ [12 0}. In ne i g hb ou ring Ni geria, t he rates reported
have r a nged from 7. t o 5 \ (8 .163) . Bec au s e labour management i n
hospitals is a l ot be tter t han t ha t whi c h occur s at home ,
where the majorit y o f wOlllen s t ill del i ver, t he actual
incidence of postpartull ha emorrhage i n t he s e c o mmunities i s
likely to be higher than t he hos p i t a l r eporte d r a t e s .
I n a prospective study of 300 women a dmi t t e d in labour i n
Egypt i n 1962 . t he ir observed haemogl Obi n levels be fo re
delivery r a ng e d fro m 7 -14 g / dl with a mea n of 11.0 g/dl ( 16 41.
Sixty-six perc ent of t he m we re j udged to be a na emic by t he
rese a r c he rs who used a cut o f f rever of l e s s t h an 12 . 6 q/d l .
S i x days aft er delivery t.heir haemoglObin levels now r ange d
from 5 .5-14.0 g/ dl . with a mean of 9 . 75 g/dl; a n av erag e
hlle moglobin decre a s e of - 1 . 29 g/d l wa s recorded. Th e study
also noted that the reductions i n ha e moglob in wer e greatest i n