Abstrakti
Objective: This study analyzes maternal deaths in a tertiary maternity in Niamey, Niger.
Methods: This is a retrospective study covering the period of one year, from January 1 to December 31 2007. The setting for this study was the Maternity Issaka Gazobi, a tertiary maternity referral centre in the city of Niamey, Niger. Data encompasses all hospital maternal deaths attributable to obstetric causes. The data were abstracted from emergency room, delivery rooms and hospitalization units’ patient files.
Results: During the study period a total of 4,582 live births were registered with a total count of 121 maternal deaths, yielding a maternal mortality ratio of 2,640/100,000 live births. The mean age of deceased mothers was 26 years with a range of 15 to 43 years, and 46% of them were 15-24 years old. The most common risk factors for maternal death were primiparity (33%), haemorrhage (30%) and anaemia (22%). Most of the maternal deaths occurred post-partum (70%), 24 died peripartum, 6 died from miscarriage or abortion in association with excessive bleeding or septic complications, and one died from etopic pregnancy. Among most deaths, the burden of morbidity was important, with 57.9% of patients admitted in a state of shock from eclampsia or acute cerebral malaria.
Conclusions: The high rate of mortality in this hospital testifies to the high morbidity of the patients, with anemia as an important risk factor. Maternal mortality in Niger remains high due to socio-economic factors, lack of access to quality care, and insufficient number of qualified health personnel.
Keywords: Maternal mortality, Niger, Sub-saharan Africa
Résumé
Cette étude avait pour objectif d’analyser les mortalités maternelles dans la maternité du centre de santé tertiaire à Niamey, Niger. Dans cette étude rétrospective durant une période d’un an du 1er Janvier au 31 Décembre 2007. La maternité d’Issaka Gazobi est un centre tertiaire de référence dans la cité de Niamey au Niger, les cas considérés étaient constitués de tous les décès du a des causes obstétriques des fichiers des patients des unités d’urgences, d’accouchements et d’hospitalisation. Les résultats montraient qu’un total de 4,582 naissances ont été enregistrés avec un total de 121 cas de décès maternel, donc une proportion de mortalité maternelle de 2,640/100,000 naissances. La moyenne d’âge des mères mortes était de 26 ans, variant entre 15 à 43 ans, et 46% de 15-24 ans. Les facteurs à risques de la mortalité maternelle les plus communs étaient la primiparité (33%), hémorragie (30%) et anémie (22%). La majorité des cas de décès maternel survenait âpres l’accouchement (70%), 24 mourraient en peripartum, 6 mouraient des avortements associés a un excès de perte de sang ou des complications septiques et un mourrait d’une grossesse ectopique. Parmi les décès, le problème de mortalité était important, ayant 57.9% des admissions en état de shocks après une éclampsie ou du paludisme cérébral aigu. En conclusion, le taux élevé de mortalité dans cet hôpital témoigne le taux de souffrance élevé des malades, avec l’anémie représentant le facteur à risque le plus important. La mortalité maternelle au Niger demeure élevé du a des facteurs socio-économiques, un manque d’accès aux soins de qualité et un nombre très insufficient du personnel qualifié.
Correspondence: Dr Amina P. Alio, University of Rochester, Department of Community and Preventive Medicine, 265 Crittenden Blvd, CU 420644, Rochester, NY 14642. E-mail: amina.alio@gmail.com
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