Abstract
Background: All pregnant women are at risk of obstetric complications and most of these complications occur during labor delivery and in the immediate postpartum period that leads to maternal death. Greater proportion of all maternal deaths results from five major complications: hemorrhage, infection, unsafe abortion, hypertensive disorders of pregnancy, and obstructed labor that all accounts for more than 70%. The maternal mortality ratio in Ethiopia is estimated to be more than 676 deaths per 100,000 live births and included in African countries with higher maternal death. Objective: This study was conducted to determine Prevalence and risk factors associated with maternal mortality in Referral Hospital. Methods: A retrospective study was conducted in Mizan-Aman General Hospital from secondary data sources of three months back in maternal health care services. The data were collected by using well-structured questionnaire from May 15 to 25, 2014. The data were entered into EpiData 3. 1 that exported to STATA 12 and SPSS 20 statistical software windows version. Discriptive analysis to determine epidemiological characteristics and inferential statistics to assess relationship of risk factors to maternal deaths were performed. Ethical clearance was separately obtained from Mizan-Tepi University Institutional review boards, Zonal health department, and additional from Referral Hospital. Results: A total of 384 maternal cases attended delivery ward of referral Hospital from February to April 2014. The estimation of mean age was 25 ± 4. 95 years, range at 95% CI. About 13(3.39%) of cases were died from obstetrical complications. The diagnosis for mothers death was obstructed labor in 3(0.78%), Puerperal sepsis 2(0.52%),multi-pregnancy in 1(0.26%),hypertensive disorder in 1(0.26%),hemorrhage in 1(0.26%),IUFD in 1(0.26%) and by non-frequent causes in 4(1.04%). The maternal death 9(7.76%) was highest in age group from 25 to 30 years. Our study suggested that death in cases with abortion was significantly low but increased death occurred in gynecological complications. Higher frequency 61(15.89%) was observed in C-section applications for maternal cases with underlying causes. Risk of maternal death was significantly related with occupation, ethnicity, age, and religion of them but not with marital and educational status in this study. Conclusion: Many indicators showed there was unacceptably high risk of maternal death in the study area. It implied that the efforts applied to revert increasing trend in maternal death produced no effect. Strong interventional measures must be designed to successfully prevent death in reproductive age group.
Highlights
Maternal mortality is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes
More than 70% of all maternal deaths are due to five major complications: hemorrhage, infection, unsafe abortion, hypertensive disorders of pregnancy, and obstructed labor
All maternal death in this study resulted due to leading causes like Sepsis, Ante-partum hemorrhage (APH), Maternal mortality review from Jimma Hospital showed that higher number of deaths occurred in high risk group, primiparous and grand multiparous but less risk of death in 2-4 parity
Summary
Maternal mortality is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. The overwhelming majority of maternal deaths occurs in developing countries and arises from the risks attributable to pregnancy and childbirth as well as from the poor performance of health services. More than 70% of all maternal deaths are due to five major complications: hemorrhage, infection, unsafe abortion, hypertensive disorders of pregnancy, and obstructed labor. The estimation of global maternal mortality ratio showed that one woman death per 200 live births observed in worldwide. All pregnant women are at risk of obstetric complications and most of these complications occur during labor delivery and in the immediate postpartum period that leads to maternal death. Greater proportion of all maternal deaths results from five major complications: hemorrhage, infection, unsafe abortion, hypertensive disorders of pregnancy, and obstructed labor that all accounts for more than 70%. The maternal mortality ratio in Ethiopia is estimated to be more than 676 deaths per 100,000 live births and included in African countries with higher maternal death
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