Introduction: Maternal mortality is a public health
problem. It is common in hospitals in Togo. From 401 per 100,000 live births in
2013, in 2017 we are 396 per 100,000 live births. Despite several programs
ranging from subsidized caesarean section (CARMA) yezou (assistance for
pregnant women), the establishment of maternal death reviews in maternity wards
to compensate for avoidable causes; we are seeing preventable maternal and
fetal deaths in our hospitals. No study on these reviews has been done since
its establishment. The objective of our study was to determine the frequency of
reviews of maternal deaths, the epidemiological, sociodemographic aspects and
the causes of these reviewed maternal deaths. Method: This was a
descriptive and cross-sectional, multicenter study lasting four and a half
years, from the 1st of January 2018 to the 30th of June
2022, relating to the review of maternal deaths in three reference hospitals of
two health regions of south Togo. Any maternal death occurring in one of these
hospitals during the study period was included in this survey. The data
collected using a collection sheet were analyzed using Epi Info version 7
software. Results: During the study period, the maternal mortality ratio
in the three hospitals was 722.3 per 100,000 live births. Only 12.2% of
maternal deaths were reviewed in the three hospitals. The patients were young
with an average age of 29.9 years, housewives (71%), uneducated (21.7%). The
causes of maternal deaths were dominated by direct obstetric causes (89.7%).
The main cause was hemorrhage (72.5%), the main cause being immediate postpartum hemorrhage (50.7%). Conclusion: This study shows that the maternal mortality ratio still remains high in our
country with a low frequency of maternal death reviews. Young, poor, uneducated
women are the most
References
[1]
World Health Organization (WHO) (2023) Maternal Mortality.
https://www.who.int/en/news-room/fact-sheets/detail/maternal-mortality
[2]
World Health Organization (WHO) (2019) Trends in Maternal Mortality 2000 to 2017: Estimates from WHO, UNICEF, UNFPA, the World Bank Group and the United Nations Population Division: Policy Summary.
[3]
Dumont, A. (2017) Reduction of Maternal Mortality in Developing Countries: What Are the Effective Interventions? Revue de médecine périnatale, 9, 7-14.
https://doi.org/10.1007/s12611-016-0390-8
[4]
Saucedo, M., Deneux Tharaux, C. and Bouvier-Colle, M.H. (2013) Epidemiology of Maternal Mortality in France, 2007-2009. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 42, 613-627. https://doi.org/10.1016/j.jgyn.2013.06.011
[5]
Aboubakari, A.S. (2006) Maternal Mortality at Kara University Hospital: Incidence, Causes and Risk Factors. SAGO Journal, 7, 21-25.
[6]
Foumsou, L., Kheba, F., Gabkika, B., Damtheou, S. and Diouf, A. (2018) Review of Maternal Deaths in Three Regional Hospitals and at the Mother and Child Hospital of N’Djamena in Chad. SAGO Journal, 19, 30-35.
[7]
Mbeva, J.B., Karemere, H., Ndeba, M., Nyavanda, L. and Mundama W’Itende, J.P. (2018) Explanatory Factors of Maternal Deaths in Hospitals: A Study in Six Health Zones in Eastern DRC Congo. International Journal of Innovation and Applied Studies, 23, 559-568.
[8]
Diassana, M., Dembele, S., Macalou, B., Ndaou, K., Sidibe, A., Bocoum, A., et al. (2020) Audits of Maternal Deaths in a Regional Hospital of Mali (Kayes), Place des 3 Retards and Impact on the Gynecology-Obstetrics Service. Health Sciences and Disease, 21, 59-63.
[9]
Djiré, M.Y. (2016) Audits of Maternal Deaths at the San Reference Health Center in Mali. Abstracts 14th Joint FIGO/SAGO/SOGOB Congress, Ouagadougou.
[10]
Barro, S.G., Zida, W.C., Savadogo, G.L.B. and Dao, B. (2016) Clinical Audit of Maternal Deaths Occurring from 2010 to 2014 in Two District Hospitals in the City of Bobo-Dioulasso. Abstracts 14th Joint FIGO/SAGO/SOGOB Congress, Ouagadougou.
[11]
Flavia, B. and Kate, G. (2015) Maternal Death Surveillance and Response (MDMR): Technical Guidelines, Prevention of Maternal Deaths, Information for Action. World Health Organization, Geneva.
[12]
Javon, D.R.D., Edem, L.A.K., Yendoube, K., Sibabe, A., Hélène, A., Christine, B., Tchilalo, A., Pou-zouwè, S., Louise, G. and Samadou, A.A. (2022) Causes of Maternal Mortality in 2020 in the Kara Region (Togo). Open Journal of Obstetrics and Gynecology, 12, 104-111. https://doi.org/10.4236/ojog.2022.121010
[13]
Public Health France (2021) Perinatal Health and Early Childhood. 6th Report of the Confidential National Inquiry into Maternal Deaths (ENCMM) 2013-2015.
[14]
UNFPA: United Nations Population Fund (2018) Prioritize the Sexual and Reproductive Rights and Health (SRHR) of Adolescent Girls and Young People in Development Programs. Balances and Populations. Senegal.
[15]
Alkassoum, I., Djibo, I., Hama, Y., Abdoulwahabou, A.M. and Amadou, O. (2018) Risk Factors for in-Hospital Maternal Mortality in the Region of Maradi, Niger (2008-2010): A Retrospective Study of 7 Regional Maternity Units. Médecine et Santé Tropicales, 28, 86-91. https://doi.org/10.1684/mst.2018.0770
[16]
Deneux-Tharaux, C. and Saucedo, M. (2017) Epidemiology of Maternal Mortality in France, 2010-2012. Gynécologie Obstétrique Fertilité & Sénologie, 45, S8-S21.
https://doi.org/10.1016/j.gofs.2017.10.025
[17]
UNFPA: United Nations Population Fund (2013) Maternal Health in Africa.
[18]
World Health Organization (2017) WHO Recommendations for Antenatal Care to Ensure a Positive Pregnancy Experience. Geneva.
[19]
Samaké, A., Traoré, S.O., Keita, M., Doumbia, S., Diallo, M., Konate, M., et al. (2020) Obstetric Sanitary Evacuations in a Second Level Reference Hospital in the Bamako District. Health Sciences and Disease, 21, 96 -99.
[20]
World Health Organization (2014) Maternal Mortality Fact Sheet, Department of Reproductive Health and Research, World Health Organization, 2014. Obstetrics and Gynecology International.