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Contribution of indirect obstetric deaths to maternal mortality at Nnamdi Azikiwe University Teaching Hospital, Nnewi.


U Ukanwa
NJ Obiechina
I Ezebialu

Abstract

Introduction: Maternal death is unacceptably high in this center like in most centers in the developing world.
Objective: To determine the maternal mortality ratio and the contribution of the direct and indirect obstetric complications to maternal deaths.
Method: A retrospective review of all maternal deaths at Nnamdi Azikiwe University Teaching Hospital Nnewi, between January, 2003 and
December 2007, a 5 year period. Maternal deaths, were identified from the labour ward, lying-in ward, sick prenatal ward, postnatal ward,
gynaecology ward records and the medical records. The total number of births was gotten from the labour ward register.
Results: There were 36 maternal deaths within the study period, and maternal mortality ratio of 1282 per 100,000 deliveries. The majority
(64%) were due to indirect causes. The most common cause was pulmonary tuberculosis (25%). Anaemia contributed 14% and, viral hepatitis 11%. Cerebral malaria, intestinal obstruction and metastatic breast cancer caused 2.8% of maternal deaths each. The direct obstetrics causes contributed 36%, with preclampsia/eclampsia 19.4%, sepsis (Septic abortion and puerperal Sepsis) 8.4%, haemorrhage 5.6% and uterine rupture 2.8%.
Conclusion: Indirect obstetric causes accounted for majority of the maternal deaths recorded within the study period.

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