Pattern of Obstetric Mortality In A Voluntary Agency Hospital In Abeokuta South West Nigeria
AbstractMost of the published works on maternal mortality in Nigeria emanate from Teaching and Specialist Hospitals although maternal deaths also occur frequently in more peripheral health facilities. The importance of studying pattern of deaths in such facilities lies in furnishing additional data to compliment the efforts of specialists in getting a better picture of this problem. An analysis of obstetric deaths over a 5-year period at Nigeria's oldest hospital, the Sacred Heart Hospital, Lantoro, Abeokuta was carried out in order to determine the pattern and causes of such deaths and what may be done to reduce their frequency.
Methods - This retrospective study of hospital records of mothers who died due to complications during or immediately after labor in the hospital between January 1994 and December 1998 were analysed for socio demographic factors, parity, booking status, duration of stay in hospital, and cause of death including information surrounding the circumstances of death were also obtained.
Results - Between January 1994 and December 1998, a total of 65 obstetric deaths were recorded. There were 21,430 deliveries, giving an overall maternal mortality ratio of 303 per 100,000 births.
There was a progressive reduction in the total yearly deliveries during the study period but a paradoxical yearly increase in maternal mortality ratio
The youngest death was recorded in a 15 year old while the age group 20-24 was more affected. Primips and grand multigravidas (70%) were the worst affected parity groups. They were mostly unbooked
The features of these deaths revealed a high and increasing maternal mortality ratio (MMR) due to largely preventable causes, of haemorrhage, sepsis, anaemia, obstructed labour and eclampsia..
Conclusion - In order for a reduction to occur in maternal deaths a deliberate expansion and modernization of the obstetric, including emergency obstetric services of the Sacred Heart Hospital, Lantoro, Abeokuta should be commenced. Assisting rural communities to establish emergency obstetric care transportation service is vital. A renewed commitment to training and retraining of community-based care providers on current methods of conducting deliveries safely, as well as early recognition and prompt referral of mothers with high risk pregnancies or complications is equally important.
The maternal mortality ratio in Abeokuta though less than the national average is unacceptably high; national socio political problems and poorly organized local health systems were the main contributory factors.
Key words: Obstetric mortality, mission hospital, Nigeria
Nigerian Medical Practitioner Vol.45(5) 2004: 83-90