Maternal and Foetal Deaths from Ruptured Spleen Following Abdominal Massage by Traditional Birth Attendants in the Niger Delta, Nigeria

Background: Abdominal massage is a harmful cultural practice sometimes leading to maternal and Foetal mortality and morbidity. Aim: To report a case of maternal and foetal deaths from abdominal massage with review of relevant literature. Method: A case of maternal and fetal deaths from abdominal massage is reported. Result: A case of a 34 year old unbooked gravida 3 para 1 1+ lady admitted at 32 weeks gestation with 2 weeks history of cough and a 3 day history of fever, labour pains and difficulty with breathing is presented. She had abdominal massage done on 2 occasions in a traditional birth attendant's home. Abdominal ultrasound revealed massive intraperitoneal fluid collection with twin intrauterine foetal death. Findings at laparotomy showed a ruptured spleen, massive haemoperitoneum of 4.5 litres and twin intrauterine foetal deaths. She died 2 hours post operatively of hypovolemic shock and cardiac arrest. Conclusion: Widespread public health enlightenment of traditional birth attendants and pregnant women on the harmful effect of abdominal massage is needed.