Hospital deaths in a high risk obstetric population: Karawa, Zaire

Three thousand four hundred thirteen consecutive deliveries at a rural hospital in Zaire are examined. 85% of patients had goiters and 5% were cretins. Twenty maternal deaths occurred, or 5.9 per 1000 deliveries. Risk factors for maternal death included late presentation, advanced age (greater than or equal to 35 years), no education and presence of goiter or cretinism. Ninety percent of women who died were in critical condition at admission, 45% had labored greater than or equal to 48 h and 70% had uterine rupture.