1.0 Introduction
1.1 Background of Study
In recent decades, the antepartum hemorrhage (APH) has expanded to a broader range of risk factors, such as placental abnormalities, multiple pregnancies, and lifestyle factors (Miller et al., 2019). Advances in imaging technology and data analysis have allowed for more detailed investigations into the prevalence and causes of APH. The emergence of large-scale epidemiological studies and meta-analyses has provided more robust data, helping to refine risk stratification and management strategies (Ghosh et al., 2021). APH is a significant obstetric issue that complicates approximately 3-5% of pregnancies, and it is associated with increased risks of adverse outcomes for both the mother and the fetus (Ghosh et al., 2021). APH occurs when there is bleeding from the genital tract after the 20th week of gestation and before the onset of labor. This condition is often linked to serious complications such as fetal distress, preterm birth, and maternal hemorrhagic shock (Smith & Brown, 2020).
Antepartum hemorrhage refers to bleeding that occurs from the genital tract after the 20th week of gestation but before the onset of labor (Levy & Goffman, 2020). It is a significant concern in obstetrics due to its potential impact on both maternal and fetal outcomes. Antepartum hemorrhage (APH) is one of the most serious obstetric complications, posing significant risks to both maternal and fetal health. It is defined as bleeding from the genital tract after 20 weeks of pregnancy but before the onset of labor, and it is a leading cause of maternal morbidity and mortality worldwide. The World Health Organization (WHO) identifies APH as a major contributor to approximately 30% of maternal deaths globally, particularly in low-resource settings (WHO, 2019). The causes of APH are often attributed to conditions such as placenta previa, placental abruption, and uterine rupture (Kumar et al., 2020).
Previous research has highlighted the need for targeted interventions to address these risk factors and improve maternal and fetal outcomes. In resource-limited settings, where access to prenatal care may be constrained, the challenges associated with APH are often exacerbated, necessitating a focused study to provide evidence-based recommendations for better management practices (Jansen et al., 2022). This background underscores the importance of investigating the prevalence and risk factors of APH to enhance healthcare strategies and reduce the incidence of this critical obstetric complication. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the prevalence and risk factors of antepartum hemorrhage among pregnant women.
1.2 Statement of Problems
Investigation revealed that antepartum hemorrhage (APH) presents a significant challenge in maternal healthcare, contributing to increased morbidity and mortality among pregnant women. Despite advancements in obstetric care, the prevalence of APH remains a pressing issue, with varying rates reported globally due to differences in healthcare systems and access (Ghosh et al., 2021).
Furthermore, the problem is compounded by a lack of comprehensive data on the prevalence and risk factors specific to different populations, which hinders the development of targeted prevention and management strategies (Smith & Brown, 2020). One major issue is the inadequate identification of risk factors that contribute to the development of APH. Factors such as advanced maternal age, history of prior cesarean sections, and hypertension are known to increase the risk, yet there is often insufficient data on how these factors interact and contribute to APH in specific settings (Miller et al., 2019). This lack of detailed information can result in suboptimal care and increased incidence of APH-related complications.
Additionally, disparities in access to quality prenatal care further exacerbate the problem. In many regions, particularly in low-resource settings, limited access to healthcare services and early detection can delay the management of APH, leading to more severe outcomes (Jansen et al., 2022).
1.3 Aim and Objectives of Study
The aim of the study is to investigate the prevalence and risk factors of antepartum hemorrhage among pregnant women. In achieving this aim, the following specific objectives were laid out as follows:
- To assess the impact of socio-demographic factors, such as socioeconomic status and access to prenatal care, on the occurrence of antepartum hemorrhage.
- To identify and analyze the major risk factors associated with antepartum hemorrhage, including maternal age, parity, history of previous pregnancies, and underlying medical conditions.
- To evaluate the relationship between placental abnormalities and the incidence of antepartum hemorrhage.
- To determine the prevalence of antepartum hemorrhage among pregnant women in the study population.
- To recommend strategies for early detection and management of antepartum hemorrhage based on the identified risk factors.
1.4 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the prevalence of antepartum hemorrhage among pregnant women in the study population?
- Which maternal characteristics are significantly associated with an increased risk of antepartum hemorrhage?
- How do socio-demographic factors, such as socioeconomic status and access to prenatal care, influence the occurrence of antepartum hemorrhage?
- What is the relationship between placental abnormalities and the incidence of antepartum hemorrhage?
- What preventive and management strategies can be recommended to reduce the risk of antepartum hemorrhage based on the identified risk factors?
1.5 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant prevalence of antepartum hemorrhage among pregnant women in the study population.
- H1: There is a significant prevalence of antepartum hemorrhage among pregnant women in the study population.
Hypothesis Two
- H0: Implementing targeted preventive and management strategies will not significantly reduce the risk of antepartum hemorrhage among pregnant women.
- H1: Implementing targeted preventive and management strategies will significantly reduce the risk of antepartum hemorrhage among pregnant women.
Hypothesis Three
- H0: Placental abnormalities, such as placenta previa and placental abruption, are not significantly associated with a higher risk of antepartum hemorrhage
- H1: Placental abnormalities, such as placenta previa and placental abruption, are significantly associated with a higher risk of antepartum hemorrhage
1.6 Significance of Study
The findings of this study will be significant for healthcare providers as they will enhance their understanding of antepartum hemorrhage, enabling them to implement more effective monitoring and intervention strategies. The research will also benefit pregnant women by providing insights into risk factors, leading to improved prenatal care and early detection practices.
Additionally, the study will contribute to the academic field by providing a foundation for future research on antepartum hemorrhage and related conditions. More so, policymakers will gain valuable data to develop and refine health policies and guidelines related to maternal care.
Finally, the study will help public health organizations to design targeted educational programs to raise awareness and prevention measures among pregnant women.
1.7 Scope of Study
The scope of the research is focused on the prevalence and risk factors of antepartum hemorrhage among pregnant women using Warri Central Hospital located at Delta State, Nigeria as a case study.
1.8 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. The study faced the following limitations.
- The research was hindered by insufficient data, which impacted the comprehensiveness and accuracy of the findings.
- Delays from respondents in providing necessary information further complicated the study's timeline and data integrity.
- Financial constraints limited the scope of the research, affecting the ability to acquire additional resources and support.
- Time constraints also restricted the depth of the study, influencing the extent of data collection and analysis.
1.9 Definition of Terms
Antepartum Hemorrhage:
Antepartum hemorrhage refers to bleeding that occurs from the genital tract after the 20th week of gestation but before the onset of labor (Levy & Goffman, 2020). It is a significant concern in obstetrics due to its potential impact on both maternal and fetal outcomes.
Prevalence:
In the context of this study, prevalence denotes the proportion of pregnant women who experience antepartum hemorrhage within a specific population during a given time period. It is typically expressed as a percentage or ratio (Gulmezoglu et al., 2016).
Risk Factors:
Risk factors are characteristics or conditions that increase the likelihood of developing antepartum hemorrhage. These may include factors such as maternal age, history of bleeding disorders, multiple pregnancies, and placental abnormalities (Cunningham et al., 2018).
Placental Abnormalities:
Placental abnormalities involve conditions where the placenta is improperly located or functions inadequately. Common types include placenta previa and placental abruption, both of which are associated with increased risk of antepartum hemorrhage (Smith & Johnson, 2019).
Maternal Health:
Maternal health encompasses the overall well-being of the pregnant woman, including pre-existing conditions such as hypertension or diabetes, which can influence the risk of antepartum hemorrhage (Williams & McCarthy, 2017).
