Maternal mortality in Ambo Hospital: a five year retrospective review

Abstract

AbstractBackground: All pregnant women are at risk of obstetric complications and most of thesecomplications occur during labour, delivery and in the immediate post-partum period thatleads to maternal deaths.Objective: The aim of this study was to analyze the magnitude, causes and identifypreventable factors leading to maternal mortality at Ambo Hospital, Ethiopia.Methods: This was a retrospective study conducted in Ambo Hospital, Western Shoa,Ethiopia, from January 2001 to December 2005. Ambo Hospital is a zonal general hospitalserving more than 2.5 million people. It has four major departments: obstetrics andgynecology, surgery, internal medicine and pediatrics. Clinical records of patients werereviewed to evaluate causative and contributing factors leading to maternal deaths. Anindependent obstetrician evaluated whether the cause of death was preventable or not.Results: There were seventy three maternal deaths during the study period. The major causesof maternal deaths were hemorrhage in 54.8 % (40/73) of women, puerperal sepsis in 30.1%(22/73) of women, hypertensive disorders in pregnancy in 12.3% of women (9/73), andhepatic encephalopathy in 2.7% (2/73) of women. The maternal mortality ratio was1,852/100,000 (73/3,941) live births. Of all the maternal deaths 97.3% (71/73) weredirect obstetric causes while only 2.7% were due to indirect obstetric causes. Of all thematernal deaths only 11% (8/73) were booked for antenatal care. The distance from hospitalto the residences of women who died was within 250 kilometers (in the range of 500 meters to250 kilometers).Conclusion: Obstetric hemorrhage, puerperal sepsis and hypertensive disorders in pregnancyare still the major causes of maternal mortality and most of these maternal deaths arepreventable. There is a need to strengthen relevant reproductive health services and projects inthe area to further improve the maternal health situation.Keywords: Obstetric complications, Prevention of maternal mortality, Avoidable maternal losses.