Determinants of Maternal Mortality at The Tambacounda Regional Hospital Centre (original) (raw)
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Open Journal of Obstetrics and Gynecology, 2017
The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indir...
Trends in maternal mortality in Tamale Teaching Hospital, Ghana
PubMed, 2011
Objective: To determine the yearly maternal mortality ratio over the period 2006-2010 and trends in the causes of 139 audited maternal deaths from 2008-2010 at the Tamale Teaching Hospital in Ghana Study design: Retrospective descriptive review of maternal deaths Setting: Department of Obstetrics and Gynaecology, Tamale Teaching Hospital Methods: Data on maternal deaths that occurred over the review period were obtained from the patient folders, departmental monthly reports, midwifery monthly returns, audit reports, theatre, intensive care unit, maternity, gynaecology and the labour ward records. Results: There were 280 maternal deaths from 1(st) January 2006 to 31(st) December 2010. The maternal mortality ratio dropped from 1870 per 100,000 live births in 2006 to 493 per 100,000 live births in 2010, a fall of nearly 74%. Using 2008 as the baseline, maternal mortality ratio dropped from 842 per 100,000 live births in 2008 to 493 per 100,000 live births in 2010, a fall of 41.4%. The main causes of 139 audited maternal deaths from 2008 to 2010 were sepsis (19.8%) hypertensive disorders(18.6%), haemorrhage (15.8%), unsafe abortion (11.5%), obstructed labour (5.7%), anaemia (8.7%), sickle cell disease (5.7%) and malaria (5.0%). The ages of the 139 audited maternal deaths ranged from 14-48 years; with mean age of 26.5 ± 4.6 years. Nearly 50% of the maternal deaths were aged 20-29 years and about 10% were 14-19 years. Eighteen(13%) of the maternal deaths were from towns over 150 km from Tamale. Conclusion: There has been significant reduction in maternal mortality at the Tamale Teaching Hospital, it is however still unacceptably high.
Tropical journal of obstetrics and gynaecology, 2009
Background : Maternal health indices are poor in Nigeria. Regular audit of maternal deaths is vital to maternal health care planning and delivery in Nigeria and other developing countries. Objectives : The aim of the study was to audit maternal deaths in EBSUTH and determine the trend and factors associated with such mortality. Method : A retrospective review and analysis of all maternal deaths between January 2004 and December 2007 at Ebonyi State University Teaching Hospital was carried out. Result : There were thirty-five deaths out of the 3471 live births during the study period giving a maternal mortality ratio (MMR) of 1,008 per 100,000 live births. This represents a 41.2% decline from the preceding immediate triennia ratio. The commonest cause of maternal death during the period were obstructed labour/ ruptured uterus which accounted for 40% of the deaths as against sepsis which was responsible for 33% of deaths in the preceding triennia. The un-booked parturients and rural d...
Open Journal of Obstetrics and Gynecology, 2018
Objective: To study causes of maternal mortality according to reports of maternal death audits in the University Teaching Hospital Bogodogo (UTH-B) of Ouagadougou, Burkina Faso. Materials and Method: This was a prospective study that took place over a year from 1 January to 31 December 2017. It concerned maternal deaths that occurred during this period in the obstetrics and gynecology department of the University Teaching Hospital Bogodogo (UTH-B). All maternal deaths were systematically audited by the audit committee; interviews with providers and families were sometimes conducted. The record books of all patients were analyzed by the audit committee; if necessary, interviews were conducted with care providers and families. The main information collected were recorded on individual files, entered and analyzed using the software Epi-info 7. Result: During the study period, we recorded 32 maternal deaths i.e., 587 per 100,000 live births. Deceased women under age 20 were the most numerous, followed by women aged 20 to 24. The death occurred in most cases in the puerperium in 69.80% of cases. Complications of pregnancy were the most incriminated causes in maternal deaths. Bleeding was the leading cause, accounting for 34.3%. They are followed by hypertensive disorders of pregnancy (21.8%) and infections (18.8%).
International journal of gynaecology and obstetrics, 1987
Ilorin over a 12-year period (1972-l 983). There were 138,577 births and 624 deaths making a maternal mortality rate of 4.50 per 1000 births. Hemorrhage, ruptured uterus and obstructed labor were the major direct obstetric causes of death. The most importunt indirect causes were cerebrospinal meningitis, pulmonary infections and fulminating hepatitis. The main avoidable factors were ineffective and cumbersome blood transfusion services; poor management of the third stage of labor; large number of unbooked patients and poor delivery room structure encouraging sepsis. Suggestions are made for a more integrated type of maternity services in our hospital, health education programs for the public and particularly the expectant women and availability of an effective blood bank service within the maternity hospital premises for prompt treatment of patients requiring emergency blood transfusion. The analysis under-I@ 1987 International Federation of Gynaecology & Obstetrics Published and Printed in Ireland lines the great problem of maternal mortality in the developing world.
Maternal Mortality in Ghana continues to be a major public health problem despite many strategies devised by the international community to reduce it. The United Nations (UN, 2009) reports indicates that more than 1500 women die each day from pregnancy related causes resulting in an estimated figure of 550,000 maternal deaths annually. This paper applies logistic regression model to determine the key factors that have significant effect to predicting the occurrence or non-occurrence of maternal mortality incidence. An annual maternal mortality data from 2007 to 2012 from Komfo Anokye Teaching Hospital (KATH) was analyzed. The results showed that AGE, PARITY and GRAVIDA contributes significantly to the occurrence of maternal mortality.
Open Access Macedonian Journal of Medical Sciences
BACKGROUND: Maternal mortality ratios (MMR) are still unacceptably high in many low-income countries especially in sub-Saharan Africa. MMR had been reported to have improved from an initial 3,026 per 100,000 live births in 1999 to 941 in 2009, at the University of Calabar Teaching Hospital (UCTH), Calabar, a tertiary health facility in Nigeria. Post-partum haemorrhage and hypertensive diseases of pregnancy have been the common causes of maternal deaths in the facility.AIM: This study was aimed at determining the trend in maternal mortality in the same facility, following institution of some facility-based intervention measures.METHODOLOGY: A retrospective study design was utilised with extraction and review of medical records of pregnancy-related deaths in UCTH, Calabar, from January 2010 to December 2014. The beginning of the review period coincided with the period the “Woman Intervention Trial” was set up to reduce maternal mortality in the facility. This trial consists of the use...
Investigating Maternal Mortality in a Public Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
Annals of Medical and Health Sciences Research, 2013
Background: Maternal mortality in sub-Saharan Africa has remained high and this is a reflection of the poor quality of maternal services. Aim: To determine the causes, trends, and level of maternal mortality rate in Abakaliki, Ebonyi. Materials and Methods: This was a review of the records of all maternal deaths related to pregnancy over a ten-year period, that is, January 1999 to December 2008. Relevant information on number of deaths, booking status, age, parity, educational level of women, mode of delivery, and causes of death were extracted and analyzed. Results: During the study period, there were 12,587 deliveries and 171 maternal deaths. The maternal mortality ratio (MMR) was 1,359 per 100,000 live births. The trend over the period was lowest in 2008 and highest in 1999 with an MMR of 757 per 100,000 live births and 4,000 per 100,000 live births, respectively. There was a progressive decline in the MMR over the period of study except in the years 2003 and 2006, when the ratio spiked a little, giving an MMR of 1,510 per 100,000 live births and 1,290 per 100,000 live births, respectively. The progressive decline in maternal mortality corresponded with the time that free maternal services were introduced. Hemorrhage was the most important cause of maternal death, accounting for 23.0% (38/165), whereas diabetic ketoacidosis, congestive cardiac failure, and asthma in pregnancy were the least important causes of maternal deaths, each accounting for 0.6% (1/165). Majority of the maternal deaths occurred in unbooked patients (82.4% (136/165)), whereas 17.6% (29/165) of the deaths occurred in booked cases. Forty-seven (28.5% (47/165)) patients died following a cesarean section, 8.5% (14/165) died as a result of abortion complications, and 10.9% (18/165) died undelivered. Seventy-seven (46.7% (77/165)) of the maternal death patients had no formal education. Low socioeconomic status, poor educational level, and grand multiparity were some of the risk factors for maternal mortality. Conclusion: There was a decline in MMR during the period of study. The free maternal health services and adequate staff recruitment, which may have contributed to the observed decline in maternal mortality, should be sustained in developing countries.
Trends in maternal mortality at the University of Calabar Teaching Hospital, Nigeria, 1999–2009
International Journal of Women's Health, 2010
but in the developing world in general. Objective: The objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital. Methodology: This was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009). All pregnancyrelated deaths of patients managed at the hospital were included in the study. Results: A total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3%) of the deaths were in women aged 20-34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%), followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%). About 69.26% of these women had no antenatal care. The majority (61.04%) died within the first 48 hours of admission. Conclusion: Although there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially Type III delay. Efforts must be put in place by government, hospital management, and society to reduce these figures further. Above all, there must be an attitudinal change towards obstetric emergencies by health care providers.
A 6-Year Review Of Maternal Deaths In A Teaching Hospital In South-South, Nigeria
The Internet Journal of Gynecology and Obstetrics, 2009
Objective: To establish the maternal mortality rate, identify causes of maternal deaths and recommend intervention measures to prevent them. Methods: The case notes of all maternal deaths at the University of Uyo Teaching Hospital, Uyo over a six year period were reviewed.Results: During the period of study, there were 3531 live births and 91 maternal deaths resulting in a maternal mortality ratio of 2,577/100,000 live births. Nulliparous women formed the largest single group (30.1%). 50.7% of the women were aged between 21-30 years while majority (83.6%) were in social classes IV and V. About 26.0% of the women booked for antenatal care, while 74.0% were unbooked. Most of the antenatal clinic defaulters (52.6%) and the unbooked women (81.5%) were brought from traditional birth attendants homes. Majority of the deaths occurred postpartum (72.6%) and within 24 hours of admission in hospital (63.0%). The most common causes of maternal deaths were eclampsia (28.8%), puerperal sepsis (17.8%) and obstetric haemorrhage (11.0%).Conclusion: Our maternal mortality rate is one of the highest in the country. Encouraging women in our environment to avail themselves of orthodox antenatal care, abolishing user fees for pregnant women and the training and integration of more professional midwives in our community are advocated.