Etiology of Obstetric Hemorrhages Associated with Maternal Deaths in a Suburban Commune of Bamako (Mali)

  • Traore Soumana O Referral Health Center of Commune V
  • Bocoum Amadou CHU Gabriel Touré
  • Fane Seydou Teaching Hospital Gabriel Touré
  • Diallo Issa Referral Health Center of Commune V
  • Sissoko Abdoulaye Teaching Hospital of Kati
  • Sima Mamadou Teaching Hospital Point G
  • Kanté Ibrahim Teaching Hospital Point G
  • Doumbia Saleck Referral Health Center of Commune V
Keywords: Obstetric hemorrhage, Maternal deaths,, RHC CV

Abstract

Objective: To determine the cause of obstetric hemorrhages associated with the occurrence of maternal deaths.
Methodology: This is a descriptive cross-sectional retrospective study at the maternity unit of the Reference Health Center of commune V (RHC CV) of the district of Bamako from January 2014 to December 2018 or 5 years. Any patients who died from obstetric hemorrhage in the antenatal, intrapartum, and postpartum periods were enrolled for the study. Each case of death was reviewed to establish the etiology of the hemorrhage, to specify the factors or even dysfunctions that led to the death, but also, and above all to determine the avoidability of death.
Results: Hemorrhage accounted for 70% of the overall maternal deaths. The mean age of the patients was 30 ± 5 years; they were not educated in 79.36% of the cases. Multipara represented 65.07% of cases. They were evacuated in 80.95% and they did not do, a prenatal check-up in 46.50%. Maternal death occurred in the postpartum period in 88.80% of cases. The causes of obstetric hemorrhage were: uterine atony (58.73%); placental retention (17.46%); birth canal trauma (11.11%) and coagulation disorders (1.60%). The Three Delays and four too were associated with maternal deaths. These deaths were avoidable in 78% of cases.
Conclusion: Immediate postpartum hemorrhage (PPH) remains predominant, with uterine atony as the first cause in the etiology of obstetric hemorrhages associated with the occurrence of maternal deaths.

Published
2021-03-23
Section
Original Articles