Babcock University Research Portal

When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country

Authors: IMARALU John

Publication Type: Journal article

Journal: British Journal Of Obstetrics And Gynaecology

ISSN Number:

Downloads

Views

Abstract

Objective: To investigate the burden and causes of life-threatening maternal complications and the quality of emergency obstetric care in Nigerian public tertiary hospitals.
Design: Nationwide cross-sectional study.
Setting: Forty-two tertiary hospitals.
Population: Women admitted for pregnancy, childbirth and puerperal complications.

Methods: All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) were prospectively identi?ed using the WHO criteria over a 1-year period.
Main outcome measures: Incidence and causes of SMO, health service events, case fatality rate, and mortality index (% of maternal death/SMO).
Results: Participating hospitals recorded 91 724 live births and 5910 stillbirths. A total of 2449 women had an SMO, including 1451 near-misses and 998 maternal deaths (2.7, 1.6 and 1.1% of live births, respectively). The majority (91.8%) of SMO cases were admitted in critical condition. Leading causes of SMO were preeclampsia/eclampsia (23.4%) and postpartum haemorrhage(14.4%). The overall mortality index for life-threatening conditions was 40.8%. For all SMOs, the median time between diagnosis and critical intervention was 60 minutes (IQR: 21– 215 minutes) but in 21.9% of cases, it was over 4 hours. Late presentation (35.3%), lack of health insurance (17.5%) and nonavailability of blood/blood products (12.7%) were the most frequent problems associated with de?ciencies in care.
Conclusions: Improving the chances of maternal survival would not only require timely application of life-saving interventions but also their safe, ef?cient and equitable use. Maternal mortality reduction strategies in Nigeria should address the de?ciencies identi?ed in tertiary hospital care and prioritise the prevention of severe complications at lower levels of care.
Tweetable abstract: Of 998 maternal deaths and 1451 near-misses reported in a network of 42 Nigerian tertiary hospitals in 1 year

Access to Documents

External Link
Download
Digital Object Identifier

Keywords

IMARALU,J. . (0000). When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country, 123 (), 928-928.

IMARALU,J. . "When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country" 123, no (), (0000): 928-928.

IMARALU,J. and . (0000). When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country, 123 (), pp928-928.

IMARALUJ, . When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country. 0000, 123 ():928-928.

IMARALU,John , . "When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country", 123 . (0000) : 928-928.

I.John , "When getting there is not enough: a nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country" vol.123, no., pp. 928-928, 0000.

Access to Documents

Keywords

About Us

Admissions

Contact Us

Policies

ALUMNI

STUDENT POPULATION