الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Despite availability of knowledge on determinants, causes, and effective clinical and public health strategies acknowledging that a substantial proportion of PPH are preventable, the goal of reducing the PPH was not achieved. This was occurred despite that maternal and newborn health has received scrutinized attention from International bodies, national governments, non-governmental organizations, and the societies (every women and ever child organization web page). Improving maternal health as one of the Millennium Development Goal (MDG 5) is the least likely to be achieved especially in the developing low source African and some Asian countries (gates foundation web page). Several factors interplay for non-achieving MDG5 goal in these countries, the least is the foundation of valid, accurate and comprehensive data (Danel et Al 2011) enable effective response that may prevent future deaths. Health disparity is another dilemma that heralds the availability of effective health services including emergency to those most in need especially in rural areas and frontiers. This is exponentially augmented by high illiteracy rate, non-affordable costs and shortage in trained manpower . Effective, low-cost interventions are available, but they are not reaching all women and neonates in need, many women deliver at home and rarely seen by a trained healthcare provider before or after delivery. In addition, the scarcity of skilled providers in poor countries which often coupled with lack to access to current management tools is another major barrier towards reduction of MMR in the developing countries .
Egypt is not exceptional and suffers the same political setbacks affecting support of health programs, resources-related issues, and manpower problems that slow its strides towards achieving the Millennium Development Goals.
We conclude that vital managerial change is required; including formulation of therapeutic protocols for primary obstetric health care services. Without these, our efforts will be useless, with little impact on saving women’s lives.
This study included 158 cases of primary postpartum haemorrhage during one year from 1st May 2020 to 30 April 2021 . The most identifiable risk factor for primary PPH was prolonged labour then anaemia. It is very important to note that the attending clinicians must always be well prepared to deal with this condition that can cost so many precious lives. The provision of safe and effective delivery care for all women in poor countries remains difficult, resulting in the continuity of avoidable maternal deaths from PPH.
Future studies should involve the effect on maternal outcomes of postpartum haemorrhage as a general country health problem. The world may give a light on these truly appalling statistics on our young mothers dying of a preventable cause in the twenty-first century.