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1.
Afr J Reprod Health ; 12(3): 35-48, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19435011

ABSTRACT

The aim of this research is to identify the clinical, demographic and service-based determinants of postpartum maternal mortality within Queen Elizabeth Central Hospital, Blantyre, Malawi, during 2001 and 2002. The study uses a case-control design using all postpartum maternal deaths in 2001 and 2002 as cases, with analysis conducted using conditional logistic regression. The results indicate that the mothers' reason for admission into hospital and the outcome of the birth were significantly related to maternal death when analysing all potential explanatory variables in one model. A group of high-risk mothers can be identified using these factors. If these criteria were applied as a predictive tool in the clinical setting the resulting sensitivity and specificity would be over 85%. Identification within the hospital setting of a group of very high-risk mothers in whom serious complications are aggressively managed in a coordinated way across the medical specialties may reduce maternal mortality.


Subject(s)
Maternal Mortality , Postpartum Period , Adolescent , Adult , Case-Control Studies , Female , Humans , Logistic Models , Malawi/epidemiology , Pregnancy , Pregnancy Outcome , Retrospective Studies , Risk Factors , Sensitivity and Specificity , Surveys and Questionnaires
2.
Article in English | AIM (Africa) | ID: biblio-1258431

ABSTRACT

The aim of this research is to identify the clinical, demographic and service-based determinants of postpartum maternal mortality within Queen Elizabeth Central Hospital, Blantyre, Malawi, during 2001 and 2002. The study uses a case-control design using all postpartum maternal deaths in 2001 and 2002 as cases, with analysis conducted using conditional logistic regression. The results indicate that the mothers' reason for admission into hospital and the outcome of the birth were significantly related to maternal death when analysing all potential explanatory variables in one model. A group of high-risk mothers can be identified using these factors. If these criteria were applied as a predictive tool in the clinical setting the resulting sensitivity and specificity would be over 85%. Identification within the hospital setting of a group of very high-risk mothers in whom serious complications are aggressively managed in a coordinated way across the medical specialties may reduce maternal mortality (Afr J Reprod Health 2008; 12[3]:35-48)


Subject(s)
Case-Control Studies , Malawi , Maternal Mortality , Postpartum Period , Risk Factors
3.
East Afr Med J ; 82(1): 3-9, 2005 Jan.
Article in English | MEDLINE | ID: mdl-16122104

ABSTRACT

BACKGROUND: Maternal mortality in Malawi continues to increase despite the global SMI and national safe motherhood programme's efforts to reduce it. OBJECTIVES: To identify the social, demographic and reproductive profiles of women suffering a maternal death, the main immediate causes and the operational factors. DESIGN: A retrospective descriptive survey. SETTING: The Gogo-Chatinkha Maternity Unit, Queen Elizabeth Central Hospital, Blantyre, Malawi, from January 1, 1999 to December 31, 2000. SUBJECTS: All women who suffered a maternal death in the unit. RESULTS: There were a total of 204 maternal deaths and 19,859 live births, giving a Maternal mortality ratio (MMR) of 1027.2/100,000 live births. Their ages ranged from 16 to 40 years. Adolescents comprised 20.6%, while the majority, (56.4%), were aged 15 - 24 years. Almost half of the group, (43.4%), were para 1 and less, with a range of 0 to 12. The top five causes of death were puerperal sepsis, (29.4%); postabortal complications, (23.5%); other infectious conditions, (20.1%); obstetric haemorrhage, (10.6%), and eclampsia, (6.4%). Some of the identified operational factors included delay in accessing and receiving emergency obstetric care, poor quality services, HIV infection/ AIDS and unsafe induced abortion following unwanted pregnancy. CONCLUSION AND RECOMMENDATIONS: Most of the causes and operational factors for maternal deaths are easily avoidable. The country needs to make more commitment and investments necessary to mitigate these deaths.


Subject(s)
Hospital Mortality , Hospitals, Teaching , Maternal Mortality , Abortion, Criminal/mortality , Adolescent , Adult , Age Distribution , Birth Rate , Cause of Death , Eclampsia/mortality , Female , Humans , Malawi/epidemiology , Maternal Age , Maternal Welfare , Middle Aged , Needs Assessment , Parity , Postpartum Hemorrhage/mortality , Pregnancy , Pregnancy Complications, Infectious/mortality , Puerperal Infection/mortality , Retrospective Studies , Risk Factors , Seasons
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