Ten years trend in maternal mortality at Kilimanjaro Christian Medical Center Tanzania, 2003–2012: A descriptive retrospective tertiary hospital based study

Abstract

To determine the trend, causes and characteristics of maternal deaths in a tertiary hospital in Northern Tanzania. A descriptive retrospective review of hospital based maternal death data that occurred at Kilimanjaro Christian Medical Center (KCMC) between the years 2003–2012. Descriptive statistics were used to summarize the socio-demographic characteristics, causes and risk factors for maternal deaths using STATA version 12. Yearly maternal mortality ratio (MMR) was calculated to estimate the trend over years under the review. Between years 2003–2012, a total of 34 953 live deliveries and 172 maternal deaths were recorded at KCMC, giving an overall MMR of 492.1/100 000 live deliveries. Direct causes accounted for 107 (62.2%) of maternal deaths, indirect causes 49 (28.5%) and 16 (9.3%) were due to both direct and indirect causes. Hemorrhage was the overall leading cause of maternal death, accounting for 33 (19.2%) of mortality, followed by hypertensive disorders in pregnancy 31 (18.0%). HIV/AIDS and Heart diseases accounted for 8.7% and 6.4% of maternal deaths, and were the leading causes of indirect maternal deaths by contributing 31% and 22% respectively. Majority 67 (38.9%) of deaths were attributed to type II delay followed by type I delay 59 (34.3%). MMR is still very high in northern Tanzania with hemorrhage and hypertensive diseases the major preventable causes of deaths. Efforts must be made at the community, lower and tertiary health facilities to improve risk detection, management of risk cases to prevent severe forms of diseases and ensure timely referrals.