Heavy bleeding, major cause of pregancy-related deaths at OAUTH —Study

Even as Nigeria works towards attaining the Millennium Development Goal of reducing maternal mortality rate by 75 per cent by the year 2015, heavy bleeding still remains the major reason women die at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, a new study has revealed.

The retrospective review of the post-mortem autopsy findings from cases of
pregnancy-related death at the hospital over a five-year period indicated that 71.4 per cent of the maternal deaths were due to direct causes and 28.6 per cent were due to indirect causes. Autopsy is an invaluable tool in accurately determining the cause of maternal death.

The study found that of the direct causes of pregnancy-related death, heavy bleeding (43.3 per cent) was the leading cause, with heavy bleeding after child birth accounting for most (65.0 per cent) of such deaths. Other causes included complications of unsafe induced abortion (33.3per cent) and of labour (11.7 per cent).

In addition, of the indirect causes, nongenital infections (50.0 per cent), anaemia (25.0 per cent), and pre-existing hypertension (20.8 per cent) accounted for the majority of the maternal deaths.

The 2014 study documented in the International Journal of Women’s Health puts the hospital’s maternal mortality rate at 1,713 per 100,000 live births.

It found that most of the deaths from heavy bleeding occurred in women aged 25 to 29 years, accounting for 34.6 per cent of these deaths. These deaths were more in women that had given birth more than four times.

In addition, about 40 per cent of these deaths were due to complications of abortion in women within the ages of 20 and 24 years. All deaths from complications of abortion were predominantly due to infection (55.0 per cent), severe bleeding (25.0 per cent), and rupture of the womb.

The researchers said it was vital that management of later stages of pregnancy, delivery and postnatal period takes into account well-defined risk factors, adding that provisions should be made for improved facilities to correctly treat these complications and  curtail these deaths, especially at the primary care level.  

They declared: “This is pertinent because most cases of maternal deaths in the tertiary care centres in Nigeria are those referred from various poorly equipped primary care centres.”

Given that infectious diseases contribute 33.3 per cent of pregnancy-related deaths, they declared that prompt diagnosis and treatment of infectious diseases during pregnancy would go a long way in reducing maternal mortality in this environment significant.

Approximately 250,000 African women are said to die yearly during pregnancy, delivery, or the first six months of child delivery. In Nigeria, about 59,000 women die every year due to pregnancy-related complications.

The average maternal mortality rate in Nigeria is estimated to be about 704 deaths per 100,000 live births, although this number ranges from about 165 deaths per 100,000 live births in the southwest region to 1,549 deaths per 100,000 live births in the north-eastern sub regions of the country.