Abstract
Objective: Analyze the maternal mortality in the two departments of CHU Point “G” in Bamako, because of high maternal mortality rate in our country. Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at CHU Point “G”. All the patients who died outside this pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0 software. The statistical test used was that of Chi2, the statistical significance threshold was fixed at 5%. Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was higher in 2014: 12.9% (50/389). The maternal death predominantly affected women aged of 20 - 24 with a frequency of 22.4% (87/389). The multiparity (166/389 making 42.7%), illiteracy (341/389 making 87.7%), the poor evacuation conditions (non-medicalized transport): 263/389 making 67.6%; the evacuation without any evacuation sheet: 259/389 making 66.6%), poor CPN (Prenatal consultation) quality (undone CPN: 191/389 making 49.1%) and the poor monitoring of delivery works (no use of partograph in 343/389 making 88.2%) were the factors favoring maternal deaths. The main causes of maternal deaths were direct in 231/389 making 59.4% with hemorrhage in first line: 21.1% (82/389), infection (61/389 cases making 15.68%), dystocia: 50 cases making 12.85% and high blood pressure and complications (38/389 making 9.76%); indirect in 158/389 cases making 40.6% (Figures 1-3). The majority of women 65.8% (256/389) of our patients died in the gynecology and obstetrics department; in the Resuscitation department 73/389 making 18.8%; in the operating room 43/389 making 11.1% and the deaths that were observed on arrivals represented 17/389 making 4.4%. In our study, 10.3% (40/389) of our patients died in the antepartum, 57.1% (222/389) in perpartum, and 32.6% (127/389) in the postpartum (Figure 4). The need not covered in blood transfusion represented 91.5% the cases either 356/389. Conclusion: The frequency of maternal deaths is very high in our country. Reducing the rate of maternal deaths requires improving the SONU (cares obstetrical and neonatal emergency).
Highlights
The death of a woman in the pregnancy-puerperal period is still experienced as a tragedy
Material and Methods: This was an analytical cross-sectional study on maternal deaths from February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died during the pregnancy-puerperal period at CHU Point “G”
The level of maternal mortality has become an indicator of the performance of the health care system because the visible part of the interventions that prevent maternal death is completely managed by the health services
Summary
The death of a woman in the pregnancy-puerperal period is still experienced as a tragedy. Expecting a child, giving him birth and hugging him are the wishes of every woman. Pregnancy if it is well carried out, leads to a live birth, and constitutes for women a criterion of social valorization. The maternal mortality ratio in developing countries in 2015 was 239 per 100,000 births, compared to 12 per 100,000 in developed countries; 99% of all the maternal deaths occur in developing countries, more than half of them in South Sahara Africa. It is the region in which the maternal mortality ratio is the highest representing 542 per 100,000. It is the region in which the maternal mortality ratio is the highest representing 542 per 100,000. [4] In Mali, several efforts have been made in the fight against the maternal mortality: The report of mortality linked to pregnancies has decreased between 2001 and 2018 from 582 per 100,000 live births to 373 per 100,000 live births in 2018 [5] [6] [7] [8]
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