Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31 st , 2015 performed at the Gynaecology Obstetrics Department of the Ignace Deen National Hospital , Conakry, Guinea. The study included women who died during pregnancy , childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40 % and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.
According to the world health organization, the maternal mortality is the death of woman during the pregnancy or within the 42 days after the termination whatever the duration and the place for any particular cause of aggravated pregnancy by the care that it motivated, but neither accidental nor fortuitous [
The objectives of this work were to:
• calculate the ratio of intra-hospital maternal mortality;
• describe the socio-demographic characteristics of the deceased patients;
• identify the main causes of maternal deaths;
• identify the three delays leading to maternal death.
This was a retrospective study of the 12-month descriptive type, from January 1st to December 31, 2015, performed at the Obstetrics and Gynaecology Department of the Ignace Deen National Hospital, CHU of Conakry. The study included women who died during pregnancy, childbirth, and in the peripheries according to the WHO’s definition of maternal death. It consisted in examining the hospitalization records for each case by a review committee made up of obstetrician gynaecologists, midwives and paediatricians. Variables were epidemiological (age, occupation, educational level, marital status, parity, source, prenatal follow-up, and death period), clinical (reasons for consultation, evolution, concordance between discharge and admission diagnoses, availability of kits, solicitation of other specialties, treatment received, type of surgery, respectability of requests for blood, delays and avoidability) and etiological.
- Ratio: We collected 38 cases of maternal death for 4404 Births, a ratio of 863 per 100,000 NV.
- Age: Patients in the age group of 20 - 24 were the most affected (26.33%) with an average of 26.26 years and extremes of 15 and 42 years.
- Profession: Housewives were the most concerned with 37%.
- Level of education: The largest number of women who died was did not go to school, 44%.
- Marital status: Married women (78%) were the most concerned.
- Parity: The nullipares were the most represented, i.e. 28.92%.
- Pregnancy follow-up: Eighteen patients (47%) who had died had no prenatal consultation.
1) Reasons for consultation: 37% of the deceased patients were admitted for haemorrhage followed by hypertension and its complications (eclampsia) (26%).
2) Evolution: 47% of the patients were consulted only after the 12th hour against 19% before the 6th hour.
3) Concordance between diagnosis of evacuation and admission: In 69% of the cases the diagnoses corresponded.
4) Availability of emergency kits: It was available for all deceased patients.
5) Solicitation of other specialties: In our study 42% of deceased patients had benefited from the demand for other specialties and 43.5% had a favorable response.
6) Honorability of the blood demand: the blood requests of 40% of the deceased patients were honored.
7) Delays: The 1st and 3rd delays were the most incriminated with respectively: 39.47% and 52.63%.
8) Causes of death: Deaths were due to direct causes in 71% of cases against 29% for indirect ones.
9) Preventable or not: In 68% of the cases the deaths were avoidable compared to 32%.
Ratio: We collected 38 maternal deaths for 4404 Live Births, a ratio of 863 per 100,000 NV. This result is close to the 724 deaths per 100,000 NV of the EDS4 Guinea 2012 [
This ratio would be related to the last-resort level of service in the country’s health pyramid with limited resources, receiving serious emergencies including “desperate ones”.
1) Age: Patients in the age group of 20 - 24 were the most affected (26.33%) with an average of 26.26 years and extremes of 15 and 42 years. This average corresponds to that recorded in 2004 in the Ivoirian series [
2) Profession: Housewives were the most concerned with 37%. The finding is similar to that found by BALDE IS in 2012 in Donka (Guinea) [
3) Level of education: The largest number of women who died was out of school, i.e. 44%. This rate of out-of-school women is in line with that of the general population in Guinea, where 74% of illiterates are women, 85.3% of whom are female, according to the Guinean EDS4 [
4) Marital Status: Married women (78%) were the most concerned. This result is close to the one found by BALDE IS in 2012 in Donka (Guinea) [
5) Parity: nullipares were the most represented or 28.92%. For N’guessan et al. [
6) Prenatal follow-up: the absence of prenatal follow-up would be a predisposing factor to death during the gravid-puerperal period with 47% of our study population. This result is close to the one found by Balde IS in 2012 in Donka (Guinea) [
1) Reasons for consultation: The occurrence of the maternal death would be related to the reason for consultation of the victim. In our series, 37% of the deceased patients were admitted for haemorrhage. The finding was similar in Gabon [
2) Evolution: The delay between the onset of symptoms and consultation predisposes to maternal death. In our study, 47% of the deceased had consulted a health facility only after the 12th hour of the appearance of the first symptom. This result corresponds to that found by BALDE IS in 2012 in Donka (Guinea) [
3) Concordance between evacuation diagnoses and admission: The two diagnoses were consistent in 69% of cases in our study is similar to that found by BALDE IS in 2012 in Donka (Guinea) [
4) Availability of emergency kits: The availability of emergency products would improve the management of patients. In our study, it was available to all deceased patients. This is to the credit of the rulers who have decreed free obstetric and neonatal care.
5) Solicitation of other specialties: In our study 42% of deceased patients had benefited from the demand for other specialties and 43.5% had a favorable response. In his series BALDE IS in 2012 in Donka (Guinea) [
6) Blood products: 40% of the deceased patients had obtained blood. This result is super imposable to that found by BALDE IS in 2012 in Donka (Guinea) [
7) Delays: The 1st and 3rd delays were the most incriminated with respectively: 39.47% and 52.63%, even observed by BALDE IS in 2012 in Donka (Guinea) [
8) Cause of death: Deaths were due to direct causes in 71% of cases against 29% for indirect ones. This result is similar to that found by BALDE IS in 2012 in Donka (Guinea) [
9) Preventable or not: Deaths are generally preventable but at various proportions: 68% in our study, 87.50% in the BALDE IS series in 2012 in Donka (Guinea) [
The reduction of this ratio would be through the provision of refocused prenatal consultation, comprehensive emergency obstetric and neonatal care, the refreshing of providers of basic facilities, and the speed with which care is taken immediately upon admission of emergencies and the availability of blood products.
The authors declare no conflicts of interest regarding the publication of this paper.
Diallo, B.S., Diallo, M.H., Balde, O., Sylla, I., Conte, I., Diallo, A., Bah, O.H., Camara, S., Balde, I.S., Sy, T., Hyjazi, Y. and Keita, N. (2019) The Maternal Deaths at the Obstetrics and Gynaecology Department of the Ignace Deen National Hospital, University Teaching Hospital (CHU) Conakry, Guinea. Open Journal of Obstetrics and Gynecology, 9, 597-603. https://doi.org/10.4236/ojog.2019.95058