Maternal mortality in Bahrain 1987-2004: an audit of causes of avoidable death

The aim of this report was to establish the national maternal mortality rate in Bahrain over the period 1987-2004, to identify preventable factors in maternal deaths and to make recommendations for safe motherhood. There were 60 maternal deaths out of 243 232 deliveries giving an average maternal mortality rate of 24.7 per 100 000 total births. The main causes of death were sickle-cell disease [25.0%], hypertension [18.3%], embolism [13.3%], haemorrhage [13.3%], heart disease [11.7%], infection [8.3%] and other [10.0%]. In an audit of care, 17 [28.3%] out of 60 deaths were judged to be avoidable, nearly half of which were due to a shortage of intensive care beds. We recommend that a confidential enquiry of maternal deaths be conducted at the national level every 3 to 5 years

Interstitial pregnancy

This report describes a case of interstitial pregnancy which was diagnosed at six weeks of gestation and treated surgically by excision. Initially, the signs and symptom were rather confusing, but the diagnosis was eventually made using ultrasound scanning. The patient was treated by excising the site of the interstitial pregnancy. The patient made a good recovery and was discharged home. Because of the question of future reproduction in such cases we have discussed alternative, minimal invasive techniques such as laparoscopic removal with or without arterial embolization, medical treatment with methotrexate or local injection with potassium hydroxide. This case was reported because it is rare, difficult to diagnose, and because modern treatment has less adverse effects on future fertility