Audit of maternal deaths in the context of free obstetrical care at the maternity of the ignace deen national teaching hospital of Conakry

Abstract

The objective of this study was to describe the evolution of half-yearly maternal mortality ratios, establish the socio-demographic profile of the deceased patient, analyze the causes and determining factors of the maternal deaths that have occurred and propose strategies for reducing this maternal mortality in said structure. Descriptive, cross-sectional and analytical study carried out at the maternity ward of the Ignace Deen National Hospital for a period of 2 years from July 1, 2018 to June 30, 2020. 224 deaths were recorded out of a total of 8,539 live births, i.e. an intra-hospital maternal mortality ratio of 2,623.25 per 100,000 live births. The profile of the deceased woman was that of patients aged 20-31 (56.26%), married (87.6%), low socioeconomic level (41.96%), multiparous (33.1%), evacuated from a peripheral maternity hospital (79.91%). The majority of deaths occurred within the first 24 hours after admission (75%); they were often due to direct obstetric causes: postpartum hemorrhage (52.68%), eclampsia (21.88%). Indirect obstetric causes were dominated by anemia (16.07%). But in some cases two or even three factors were associated in the occurrence of the same death. The obstetric period of death was often postpartum (77.68%). The lack of blood products and insufficient technical facilities were the main associated factors. Reducing maternal mortality requires good health education, improving the quality of antenatal care and emergency obstetric care.