Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates
Data on maternal morbidity make it possible to assess how many women are likely to need essential obstetric care, and permit the organization, monitoring and evaluation of safe motherhood programmes. In the present paper we propose operational definitions of severe maternal morbidity and report the...
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The World Health Organization
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| Series: | Bulletin of the World Health Organization |
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| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000500004&lng=en&tlng=en |
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| author | A. Prual M.-H. Bouvier-Colle L. de Bernis G. Bréart |
| author_facet | A. Prual M.-H. Bouvier-Colle L. de Bernis G. Bréart |
| author_sort | A. Prual |
| collection | DOAJ |
| description | Data on maternal morbidity make it possible to assess how many women are likely to need essential obstetric care, and permit the organization, monitoring and evaluation of safe motherhood programmes. In the present paper we propose operational definitions of severe maternal morbidity and report the frequency of such morbidity as revealed in a population-based survey of a cohort of 20 326 pregnant women in six West African countries. The methodology and questionnaires were the same in all areas. Each pregnant woman had four contacts with the obstetric survey team: at inclusion, between 32 and 36 weeks of amenorrhoea, during delivery and 60 days postpartum. Direct obstetric causes of severe morbidity were observed in 1215 women (6.17 cases per 100 live births). This ratio varied significantly between areas, from 3.01% in Bamako to 9.05% in Saint-Louis. The main direct causes of severe maternal morbidity were: haemorrhage (3.05 per 100 live births); obstructed labour (2.05 per 100), 23 cases of which involved uterine rupture (0.12 per 100); hypertensive disorders of pregnancy (0.64 per 100), 38 cases of which involved eclampsia (0.19 per 100); and sepsis (0.09 per 100). Other direct obstetric causes accounted for 12.2% of cases. Case fatality rates were very high for sepsis (33.3%), uterine rupture (30.4%) and eclampsia (18.4%); those for haemorrhage varied from 1.9% for antepartum or peripartum haemorrhage to 3.7% for abruptio placentae. Thus at least 3-9% of pregnant women required essential obstetric care. The high case fatality rates of several complications reflected a poor quality of obstetric care. |
| first_indexed | 2024-03-07T18:51:36Z |
| format | Article |
| id | doaj.art-b3d8edaab9ce4ca992ea5771b04ba682 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:51:36Z |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-b3d8edaab9ce4ca992ea5771b04ba6822024-03-02T01:35:03ZengThe World Health OrganizationBulletin of the World Health Organization0042-968678559360210.1590/S0042-96862000000500004S0042-96862000000500004Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality ratesA. Prual0M.-H. Bouvier-Colle1L. de Bernis2G. Bréart3Ministère de la Santé et des Affaires SocialesInstitut National de la Santé et de la Recherche MédicaleMinistère de la Santé et des Affaires SocialesUniversité Paris VIData on maternal morbidity make it possible to assess how many women are likely to need essential obstetric care, and permit the organization, monitoring and evaluation of safe motherhood programmes. In the present paper we propose operational definitions of severe maternal morbidity and report the frequency of such morbidity as revealed in a population-based survey of a cohort of 20 326 pregnant women in six West African countries. The methodology and questionnaires were the same in all areas. Each pregnant woman had four contacts with the obstetric survey team: at inclusion, between 32 and 36 weeks of amenorrhoea, during delivery and 60 days postpartum. Direct obstetric causes of severe morbidity were observed in 1215 women (6.17 cases per 100 live births). This ratio varied significantly between areas, from 3.01% in Bamako to 9.05% in Saint-Louis. The main direct causes of severe maternal morbidity were: haemorrhage (3.05 per 100 live births); obstructed labour (2.05 per 100), 23 cases of which involved uterine rupture (0.12 per 100); hypertensive disorders of pregnancy (0.64 per 100), 38 cases of which involved eclampsia (0.19 per 100); and sepsis (0.09 per 100). Other direct obstetric causes accounted for 12.2% of cases. Case fatality rates were very high for sepsis (33.3%), uterine rupture (30.4%) and eclampsia (18.4%); those for haemorrhage varied from 1.9% for antepartum or peripartum haemorrhage to 3.7% for abruptio placentae. Thus at least 3-9% of pregnant women required essential obstetric care. The high case fatality rates of several complications reflected a poor quality of obstetric care.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000500004&lng=en&tlng=enafricawesternlabour complicationslabour complicationsmaternal mortalityrisk factorsprospective studieslongitudinal studies |
| spellingShingle | A. Prual M.-H. Bouvier-Colle L. de Bernis G. Bréart Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates Bulletin of the World Health Organization africa western labour complications labour complications maternal mortality risk factors prospective studies longitudinal studies |
| title | Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates |
| title_full | Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates |
| title_fullStr | Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates |
| title_full_unstemmed | Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates |
| title_short | Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates |
| title_sort | severe maternal morbidity from direct obstetric causes in west africa incidence and case fatality rates |
| topic | africa western labour complications labour complications maternal mortality risk factors prospective studies longitudinal studies |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862000000500004&lng=en&tlng=en |
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