Review of Maternal Mortality Cases at Loandjili General Hospital in Pointe-Noire

Objectives: A major global public health problem, maternal mortality remains high, especially in the sub-Saharan countries, despite the efforts of the various health systems. Thus, this work was intended to describe the epidemiological profile of deceased patients, to identify the causes of maternal mortality, and to report dysfunctions in relation to management facilities. Methods: Descriptive cross-sectional study, conducted from 1 January 2012 to 31 December 2014 at Loandjili General Hospital, including cases of maternal deaths occurring in the Obstetrics Gynecology Department. Maternal mortality has been defined in accordance with the World Health Organization, as “the death of a woman occurring during pregnancy or within 42 days after delivery, regardless of the cause or aggravated by the pregnancy or the care she has motivated, but neither accidental nor fortuitous “. The review of each file allowed us to analyse the epidemiological, clinical and therapeutic variables, and to deduce dysfunctions related to the commodities (human, material and financial) of management. Results: Eighty-three maternal deaths were recorded out of 8,115 live births, representing a maternal mortality ratio of 1022 / 100,000 live births. Patients who died had a median age of 28.8 years [23.5; 34], secondary school (54%), pauciparous (2.9 ± 1.4 years), unemployed (75%), and referred (64%) in poor condition (76%). Caesarean section was performed in 29% of cases. The causes of death were haemorrhage (46%), complications of arterial hypertension (25%) and abortion (17%). In 60% of the cases, the deceased patients would have benefited from a surgical intervention, but only 37% of them were operated on. The deaths occurred during pregnancy (48%), childbirth (16%) and in the postpartum (36%). The unavailability of blood products and inputs was reported in 60% and 23% of cases, respectively. The third delay was noted in 90% of cases. Conclusion: The maternal mortality in our maternity with modest resources would be multifactorial, in relation with the patient, the clinical state, the health structure and the environment. Full management of the patient (medico-social), prenatal quality contacts and knowledge of warning signs, would contribute to the reduction of maternal mortality.