Investigation and Analysis of Maternal Mortality in Obstetrics and Anesthesia Resuscitation in 15 Years at U.H.C Point “G” about 389 Cases Bamako/Mali

Objective: Maternal mortality constitutes an unacceptable social injustice in the world. The health
future of society depends on the health of today's children and that of their mothers, who are the
guarantors of that future. Analyze the maternal mortality in the two departments of CHU Point “G” in
Bamako, because of high maternal mortality rate in our country.
Materials and Methods: This was an analytical cross-sectional study on maternal deaths from
February 19, 2005 to November 19, 2019 for patients admitted in both departments and who died
during the pregnancy-puerperal period at UHC Point “G”. All the patients who died outside this
pregnancy-puerperal period were not retained. The data were entered and analyzed using SPSS 12.0
software. The statistical test used was that of Chi2, the statistical significance threshold was fixed at
5%.
Results: During our study, we recorded 389 maternal deaths out of 16,033 admissions in 15 years
and 18,060 live births during the same period making a maternal mortality ratio of 2153.931 and a
frequency of 2.426. At the end of our study, we noted that the frequency of maternal deaths was
higher in 2014: 12.9% (50/389). The maternal death predominantly affected young women aged of 20
- 24 with a frequency of 22.4% (87/389). The multiparity represented 42.7% (166/389), illiteracy
87.7% (341/389), the poor evacuation conditions (non-medicalized transport): 67.6% making 263/389;
the evacuation without any evacuation sheet: 66.6% making 259/389, poor CPN (Prenatal
consultation) quality (undone CPN: 49.1% making 191/389) and the poor monitoring of delivery works
(no use of partograph in 88.2% making 343/389) were the factors favoring maternal deaths. The main
causes of maternal deaths were direct in 59.4% making 231/389 with hemorrhage in first line: 21.1%
(82/389), infection (15.68% making 61/389 cases), dystocia: 12.85% making 50 cases and high
blood pressure and complications (9.76% making 38/389); indirect in 40.6% making 158/389 cases
(Figs. 1-3). The majority of women 65.8% (256/389) of our patients died in the gynecology and
obstetrics department; in the Resuscitation department 18.8% making 73/389; in the operating room
11.1% making 43/389 and the deaths that were observed on arrivals represented 4.4% making
17/389. In our study, 10.3% (40/389) of our patients died in the antepartum, 57.1% (222/389) in
perpartum, and 32.6% (127/389) in the postpartum (Fig. 4). The need not covered in blood transfusion
represented 91.5% the cases either 356/389.
Conclusion: The frequency of maternal deaths is very high in our country. Poor monitoring of
pregnancy and childbirth as well as poor evacuation conditions are the contributing factors. Thus,