A 3 YEARS REVIEW OF MATERNAL DEATH AND ASSOCIATED FACTORS AT AYDER COMPREHENSIVE SPCIALIZED HOSPITAL, NORTHERN ETHIOPIA

Abstract

ABSTRACT BACKGROUND: Maternal mortality ratio in Ethiopia is one of the highest in the world. Despite measures to alleviate it and showing a promising declining trend, it still remains one of the highest at 412 maternal deaths per 100,000 live births. To our knowledge there is no accessible published study on maternal mortality at Ayder Comprehensive Specialized Hospital (ACSH). OBJECTIVE The aim of this study is to systematically analyze causes of maternal deaths and contributing factors at (ACSH).METHODS This was a descriptive, retrospective chart review of institutional maternal deaths using a 3-years record from July 1, 2014 – June 30, 2017 at ACSH.RESULTS There were 52 maternal deaths from July 1, 2014 – June 30, 2017 at ACSH. The main causes of these deaths were related to obstetric hemorrhage (n=11, 21.2 %), hypertensive disorders of pregnancy (n=10, 19.2%) and sepsis (n=7, 13.5%). About 86.5% (n=45) of the mothers were referral cases of whom 24 (53.33%) of them travelled more than 100 kilometers to reach ACSH. The furthest referral site was 498 kilometers from ACSH. Most common reasons for referral include for admission to intensive care unit, for further workup and management, for blood transfusion and for high risk admission. Most of the maternal deaths occurred in the postpartum period.CONCLUSIONThere is an urgent need for expansion of intensive care unit (ICU) and availing blood transfusion services in all the general and regional hospitals with close monitoring of mothers in the postpartum period. The referral system needs coordinnation from the lower level to the teritirary care centers. KEY WORDS: Maternal death, cause of maternal death, factors for maternal death, Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia (Ethiopian Journal of Reproductive Health 2018; 10; 3: 38-45)