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Abstract
Objectives: Analyze the determinants of obstetric lethality in the Department of Obstetrical Gynecology at the University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO) of Ouagadougou from 2015 to 2018. Methodology: We conducted an analytical, descriptive cross-sectional study on maternal deaths in the UTH-YO. The data were collected retrospectively. All patients meeting the World Health Organization (WHO) definition of maternal death and patients who died as a result of direct obstetric complications in the Department of Gynaecology and Obstetrics at the University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO) of Ouagadougou from January 1, 2015 to December 31, 2018 were included. Results: We recorded 484 maternal deaths and 22947 births, for a maternal mortality ratio of 2109 deaths per 100,000 live births (NV). Patients who died as a result of direct obstetric complications accounted for 412 out of 10,564 cases, representing an obstetric lethality rate of 3.9%. These were patients with an average age of 27.6 years, without income generating activities (93.6%), nulliparous and pauciparous patients respectively (26%) and (31%). Most of them came from health facilities in the city of Ouagadougou (50%). The 4 main causes of death were haemorrhages (29.7%), hypertensive disorders (20.8%), abortion complications (16.8%) and infections (14%) respectively. The most lethal causes were thromboembolic pathology (27.27%), infections (13%), abortion complications (7.6%), bleeding (5.4%) and hypertensive disorders (4.2%). The notion of the 3 delays, the insufficient technical platform, the lack of financial resources and the lack of staff qualification were the contributing factors to the causes of death. Conclusion: From our study, it appears, as elsewhere, that most maternal deaths are preventable, hence the need for coordinated action to take effective action against maternal mortality.
Highlights
In Burkina Faso, the maternal mortality ratio was 307 per 100,000 NV in 2010 [13]
It should be noted that the main causes of maternal deaths in Burkina Faso are haemorrhages, infections, complications of unsafe abortions, hypertensive disorders and dystocias [13, 14, 21]
The variables taken into account were: marital status, age, occupation, marital status, mode of admission, origin, time of evacuation, reason for evacuation, distance travelled to University Teaching Hospital Yalgado OUEDRAOGO (UTH-YO), history, pregnancy follow-up, clinical signs, diagnoses selected, therapeutic modalities, causes, time of death and factors contributing to maternal deaths
Summary
It should be noted that the main causes of maternal deaths in Burkina Faso are haemorrhages, infections, complications of unsafe abortions, hypertensive disorders and dystocias [13, 14, 21]. According to the national committee for monitoring the implementation of maternal and neonatal mortality reduction strategy programmes: in 2012 there were 702 cases of maternal death compared to 532 cases of maternal death in 2013 [14, 21]. This decrease in mortality is explained by strategies such as the creation of medical centres with surgical antenna, training of health centre providers, state subsidies to emergency. The points of service increased from 25% in 2012 to 75% in 2013 [14]
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