Background: One of the reason of the cause of high maternal mortality rate is delayed of referring patients to hospital in postpartum hemmorhage cases.
Objective: to determined the relationship between delayed referral by midwife in postpartum hemmorhage cases and near-miss morbidity at Soeradji Tirtonegoro Klaten hospital from January 2009 until December 2010.
Methods: A cohort retrospective study was conducted in 191 women with postpartum hemmorhage. The population of this study are all of the postpartum hemorrhage cases referred by midwife to Soeradji Tirtonegoro Klaten hospital. Subjects in this study are those who met inclusion and exclusion criteria, consisting of a group of mothers with postpartum hemorrhage cases that were referred by midwife. Criteria for inclusion in this study were all cases of postpartum hemorrhage that was referred to Dr Soeradji Tirtonegoro Klaten hospital.
Results: There were significant relationship between status of midwife and midwife’s workplace with delayed of referring patient to hospital (p: 0,003 and p: 0,001; p< 0.05). The length of working period of midwife and the education of midwife have significantly influenced the occurrence of near miss (RR = 1.328 and 95%CI 1.027-1.717; RR=1.288 and 95%CI 1.047-1.585 ; RR =1.434 and 95%CI 1.155-1.782). We found that delayed of referring patients to hospital, status of midwife, the length working period of midwife and the education of midwife are the risk factors of near-miss morbidity in postpartum hemorrhage cases (OR > 1).
Conclusion: The incidence of morbidity nearmiss in cases of postpartum hemorrhage in the late group were referred by midwives is higher than the group that was not too late referenced
Keyword: referred by midwife, postpartum hemorrhage, near-miss morbidity