TITLE:
Maternal Hospital Mortality in Cotonou: Incidence, Care-Associated Adverse Events and Causes
AUTHORS:
Djima Patrice Dangbemey, Cedric Bigot, Ogourindé Mathieu Ogoudjobi, Moufalilou Aboubakar, Raoul Atade, Paterne Kpoviessi, Hounkpatin Benjamin, Christiane Tshabu-Aguemon, Josiane Angeline Tonato-Bagnan, Justin Lewis Denakpo
KEYWORDS:
Maternal Mortality, Adverse Events, Care, Cotonou
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.10,
October
12,
2023
ABSTRACT: Introduction: Despite the many efforts made to combat preventable maternal deaths,
these still remain high in Benin. It was
therefore important to revisit the causes but especially the adverse events
associated with care (EIS) in maternity. Objective: Determine the
incidence, adverse events associated with care and causes of intra hospital
maternal mortality in cotonou. Methods: This was a cross-sectional
maternal mortality review study with retrospective data collection. It covered
all cases of maternal death recorded between 2017 and 2021 in two (2) reference
university maternities in Cotonou. Adverse events associated with care and the
patient were analyzed using the maternal death audit grid validated for Benin.
SPSS.26 software was used for data analysis. Results: The in-hospital
maternal mortality ratio in Cotonou was 2028 maternal deaths per 100,000 live
births in 2021. Only 7.2% (n = 36) of deaths were audited. The deceased mothers
were 29.8 ± 7.4 years old, with no fixed monthly income in 82.7% (n = 420).
Serious adverse events associated with care were: delay in decision to refer in
37% (n = 188), non-medical referral in 85.8% (n = 436) of cases, inadequate
pre-referral treatment in 25.7% of
cases. In receiving maternities, delay in diagnosis and inappropriate treatment
at the receiving maternity were noted respectively in 22.9% and 28.6% of cases
of maternal death. The direct causes of maternal death were dominated by
serious obstetric hemorrhage in 43.9% (n = 223). As for the indirect causes,
they were dominated by anemia excluding obstetric hemorrhages in 21.5% (n =
109). Conclusion: The in-hospital maternal mortality ratio was very high
in Cotonou. The main cause was severe obstetric hemorrhage. There were several
serious healthcare-associated adverse events whose correct management would
significantly reduce the incidence of maternal deaths.