Maternal mortality ratio in a tertiary hospital offering free maternity services in South-western Nigeria – A five-year review

Abstract

Aim: To determine annual trends of maternal mortality ratio in a tertiary hospital offering free maternity services.Settings and Design: This retrospective descriptive study was conducted at the Mother and Child Hospital Akure, Ondo State, a busy purpose-built tertiary care facility premised on evidence-based protocol management of patients and offering free consultations, admissions, drugs, laboratory tests, blood transfusions and surgeries.Materials and Methods: Data were collected from available hospital records from inception on 24th February 2010 to 31st December 2014 and analysed using Microsoft Excel 2010 software.Statistical Analysis: Data analysis was done using descriptive statistics. Categorical variables were expressed as frequency (percentage) and continuous variables as mean, median and range.Results: In the 5-year period, antenatal registration was 49195; increasing from 7378 in 2010 to 12002 in 2013 (63% increase) before dipping to 9780 in 2014. Number of births was 30031; increasing from 3673 in 2010 to 7634 in 2013 (108% increase) before dipping to 6234 in 2014. The overall maternal mortality ratio was 383 per 100,000 births reducing from 708 in 2010 to 208 in 2014 (70% reduction). The most common causes of maternal deaths were postpartum haemorrhage (30%), eclampsia (29%) and uterine rupture (14%).Conclusions: Over 5 years, a busy tertiary maternity centre premised on evidence-based protocol management of patients and offering free services had a sustained reduction in facility-based maternal mortality ratio. It is, therefore, recommended that the model be adopted in all public maternity centres.