Maternal mortality in Ambo Hospital: a five year retrospective review

Abstract

Abstract
Background: All pregnant women are at risk of obstetric complications and most of these
complications occur during labour, delivery and in the immediate post-partum period that
leads to maternal deaths.
Objective: The aim of this study was to analyze the magnitude, causes and identify
preventable factors leading to maternal mortality at Ambo Hospital, Ethiopia.
Methods: This was a retrospective study conducted in Ambo Hospital, Western Shoa,
Ethiopia, from January 2001 to December 2005. Ambo Hospital is a zonal general hospital
serving more than 2.5 million people. It has four major departments: obstetrics and
gynecology, surgery, internal medicine and pediatrics. Clinical records of patients were
reviewed to evaluate causative and contributing factors leading to maternal deaths. An
independent obstetrician evaluated whether the cause of death was preventable or not.
Results: There were seventy three maternal deaths during the study period. The major causes
of maternal deaths were hemorrhage in 54.8 % (40/73) of women, puerperal sepsis in 30.1%
(22/73) of women, hypertensive disorders in pregnancy in 12.3% of women (9/73), and
hepatic encephalopathy in 2.7% (2/73) of women. The maternal mortality ratio was
1,852/100,000 (73/3,941) live births. Of all the maternal deaths 97.3% (71/73) were
direct obstetric causes while only 2.7% were due to indirect obstetric causes. Of all the
maternal deaths only 11% (8/73) were booked for antenatal care. The distance from hospital
to the residences of women who died was within 250 kilometers (in the range of 500 meters to
250 kilometers).
Conclusion: Obstetric hemorrhage, puerperal sepsis and hypertensive disorders in pregnancy
are still the major causes of maternal mortality and most of these maternal deaths are
preventable. There is a need to strengthen relevant reproductive health services and projects in
the area to further improve the maternal health situation.
Keywords: Obstetric complications, Prevention of maternal mortality, Avoidable maternal losses.