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  • Title: Maternal complications--in a zonal hospital.
    Author: Gessessew A.
    Journal: Ethiop Med J; 2007 Jan; 45(1):47-54. PubMed ID: 17642157.
    Abstract:
    BACKGROUND: The maternal mortality ratio in developing countries is still very high. The causes of maternal mortality varies in different parts of the world. Knowledge of the incidence of maternal complication and associated maternal mortality is vital in designing preventive strategies. There are only few reports about their issue in Ethiopia. OBJECTIVES: To describe the frequency of maternal complications and associated maternal mortality in Adigrat zonal hospital. PATIENTS AND METHODS: A retrospective review of the delivery registration book of all labouring mothers admitted to the labour ward from April 1, 1993 to March 30, 2003 was carried out. RESULTS: A total of 7249 mothers delivered in the above mentioned hospital and 16.5% of the mothers were below the age of 20, 44.9% were nulliparous, and grandmultiparity accounted for 12.5% of them. Most (56.2%) had Antenatal care (ANC). The complications identified were. preterm labour (7.2%), premature rupture of the membranes (PROM) (6%), pre-eclampsia (5.2%), malpresentation (8.7%), Antepartum hemorrhage (APH) (2.7%), obstructed labour (3.5%) and postpartum hemorrhage (PPH) (6.7%) . There were 32 maternal deaths and the presumed causes of deaths were: Ruptured uterus (25%), obstructed labor (78.8%), hemorrhage (28.1%), eclampsia (15.6%), and sepsis (12.5%). The highest case fatality ratio was found with ruptured uterus (11.8%), eclampsia (11.1%) and hemorrhage (9.3%). The prevalence of severe obstetric morbidity was 6.4% and the case fatality ratio 6.1%. The caesarean section rate was 8.5% and maternal indications contributed for majority of the indications (58.8% of the cases). Low birth weight was found in 11.2% of the neonates. CONCLUSION: The frequency of severe maternal morbidity is high & is associated with high case fatality ratio. This indicates the need of improvement in the quality of obstetric care to prevent maternal complications. Community based studies are recommended to establish the real picture of the situation.
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