Contribution of direct obstetric complications to maternal deaths in Makurdi, North-Central Nigeria

Context: The Federal Medical Centre Makurdi is the only tertiary health institution in Benue State. Maternal deaths are a frequent occurrence in the centre thereby necessitating this study. Objective: To determine the maternal mortality ratio, the case fatality rate and the contribution of direct obstetric complications to these deaths. Subjects and Methods: A four month descriptive study of obstetric service data from 1 January to 30 April 2004.Results: During the study period, there were a total of 363 deliveries (52% unbooked, 48% booked, 20% DOC.) and 16 maternal deaths (94% were direct) giving a maternal mortality ratio of 4 408 / 100 000 deliveries.14 (87.5%) of the deaths were unbooked obstetric emergencies. The overall case fatality rate (CFR) was 21%. The contribution of each direct obstetric complication to the direct maternal deaths was as follows: obstructed labour/ ruptured uterus (53.3 %), postpartum haemorrhage (13.35%), puerperal sepsis (13.35 %), Eclampsia (6. 68 %), induced Abortion (6.68 %). The cause- specific CFR was in this order. Ruptured uterus 100%, Puerperal sepsis 100%, Abortion 25%, severe Preeclampsia/Eclampsia 20%, Obstetric haemorrhage 12.5%, obstructed labour 11.4%. The caesarean section rate was 15 %. Facilities to provide life saving functions were lacking and staff commitment was low. Conclusion: Urgent emergency obstetric care training of residents and provision of parenteral antibiotics, anticonvulsants, oxytocics and safe blood for transfusion is recommended. Keywords: maternal mortality, direct obstetric complications, Nigeria Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 22: 37-3