Changing trends in maternal mortality in a developing country

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• Maternal mortality remains a significant global health challenge.
• Understanding local trends in maternal mortality is essential for targeted interventions.

Purpose of the Study:

• To conduct a 5-year review of the maternal mortality ratio (MMR) and its causes.
• To analyze trends and identify key factors contributing to maternal deaths at a central mission hospital in Benin City.

Main Methods:

• Retrospective review of maternal mortality cases from January 1, 1996, to December 31, 2000.
• Extraction of data from case notes, registers (labor, antenatal, postnatal, female ward, theatre), and death certificates.
• Calculation of Maternal Mortality Ratio (MMR) per 100,000 live births.

Main Results:

• A total of 7055 deliveries resulted in 32 maternal deaths, yielding an MMR of 454/100,000 live births.
• Unbooked emergencies constituted 68.7% of deaths, with MMR peaking in 1999.
• Leading causes included eclampsia (34.4%), hemorrhage (25.0%), infections (18.8%), and abortions (12.5%).

Conclusions:

• The MMR is unacceptably high, with largely preventable causes.
• The puerperium period presents the highest risk.
• Recommendations include enhancing women's empowerment, providing subsidized antenatal care, improving emergency obstetric services, and increasing community awareness for early risk recognition and management.