Universal Journal of Public Health 3(4): 153-159, 2015 http://www.hrpub.org DOI: 10.13189/ujph.2015.030403 Incidence, Contributing Factors and Outcomes of Antepartum Hemorrhage in Jimma University Specialized Hospital, Southwest Ethiopia Nega Chufamo 1 , Hailemariam Segni 2,* , Yibeltal Kiflie Alemayehu 3,4 1 Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences Arba Minch University, Ethiopia 2 Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Jimma University, Ethiopia 3 Department of Health Systems Management, School of Public Health, College of Health Sciences, Jimma University, Ethiopia 4 Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, USA Copyright © 2015 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License Abstract Background: Antepartum haemorrhage complicates three to five percent of pregnancies contributing to perinatal and maternal morbidity and mortality. Timely access to quality obstetric services is the major determinant of both maternal and newborn outcomes after antepartum haemorrhage. In Ethiopia, the magnitude and consequences of antepartum haemorrhage are not well studied. The objective of this study was to determine the incidence, factors associated with and maternal and perinatal outcomes of antepartum haemorrhage in Jimma University Specialized Hospital. Methods: A hospital-based prospective cohort study was conducted in Jimma University Specialized Hospital, from January 1 to December 31, 2013. Data were collected by reviewing medical records and interviewing mothers. Cumulative incidence of antepartum hemorrhage among mothers who gave birth and odds of adverse outcomes among mothers with and without antepartum hemorrhage were calculated. Odds ratio was calculated to estimate the effect of antepartum hemorrhage on maternal and new born adverse outcomes. Results: Between January and December 2013, 3854 women gave birth in JUSH. The incidence of antepartum hemorrhage was 5.1% (n=195) in 2013. The major causes of antepartum hemorrhage were abruptio placentae and placenta previa occurring in 127(65.1%) and 52(26.7%) of cases, respectively. Six (3.1%) of the patients with antepartum hemorrhage died. Of the 206 babies born, 63 (30.6%) were stillborn and additional 13 (6.3%) newborns died during the first seven days of life making perinatal mortality rate of 36.9%. Conclusion: Antepartum hemorrhage is a common complication of pregnancy and cause of maternal and perinatal mortality in Jimma University Specialized Hospital. The risk of adverse outcomes is very high compared to other countries. Efforts to improve access and quality of comprehensive emergency obstetric care services are required. Keywords Antepartum Hemorrhage, Placenta Previa, Abruptio Placentae, Maternal Mortality, Perinatal Mortality 1. Introduction Adverse pregnancy outcomes including maternal and perinatal morbidity and mortality constitute major public health problems in the developing world. The risk of dying from maternal causes is 100 times higher for women in developing countries compared to those in developed countries. Developing countries contribute to 99% of the world’s maternal deaths (1, 2). In 2013, sixty percent of Sub-Saharan African countries had a Maternal Mortality Ratio (MMR) of above 400 maternal deaths per 100,000 live births (3). Ethiopia has one of the world’s highest MMRs at 676 maternal deaths per 100,000 live births in 2011(4), showing no reduction from its 2005 level of 673 maternal deaths per 100,000 live births (5). Despite reductions observed during the last decade, perinatal mortality also remained high compared to other developing and developed countries (6). For the period 2006 to 2011, the average perinatal mortality rate in Ethiopia was 46 perinatal deaths per 1,000 pregnancies of seven or more months of gestation (4). Obstetric haemorrhage remains one of the major causes of maternal deaths (7-10), and one of the primary obstetric causes of perinatal mortality (11-13). Antepartum hemorrhage (APH), bleeding from the genital tract of a pregnant mother with a viable fetus before the onset of labour, complicates 3.5% of pregnancies and it constitutes one of the reasons for emergency hospital visits among pregnant women (14, 15). Abruptio placentae and placenta previa are the major causes of APH (16, 17). Even though a number of obstetric and non-obstetric situations are identified as risk factors for APH (17-21); it still remains a predominantly unpredictable condition (14). Access to quality basic and emergency obstetric care services remains