[Pregnancy and delivery in western Africa. High risk motherhood]

According to the World Health Organization, 585,000 women die each year from a pregnancy-related cause, 99% of whom are from developing countries. The first International Conference on Safe Motherhood in 1987 sensitized the world community to this drama. Ever since, maternal mortality and its medical causes are better known. The maternal mortality ratio is highest in West Africa (1,020 maternal deaths per 100,000 live borns) when it is 27/100,000 in industrialized countries. Direct obstetric causes account for 80% of the deaths: hemorrhage, infection, dystocia, hypertension and abortion. Indirect causes are essentially anemia, malaria, hepatitis C and AIDS. Severe maternal morbidity is 6 to 10 times more frequent than maternal mortality but it also leads to handicaps which end up often in women's social rejection. However, WHO estimates that 95% of these deaths and handicaps are avoidable, and at a low cost.