Trends in Direct Causes of Maternal Deaths as Seen at The Korle-Bu Teaching Hospital Mortuary (1995 –2014): A Retrospective Autopsy Study

Abstract

Objectives: Our main research aim was to describe the relative proportions and trend of direct causes of maternal death over a period of 20-years in the largest tertiary hospital in Ghana.
Material and methods: This was a descriptive retrospective review of cases of maternal death for which autopsy examination was conducted at the KBTH mortuary from 1995 to 2014. Data on direct maternal deaths were collected on the age, local of death (coroner
and permission), the anatomical site and diagnosis: 1) obstetric haemorrhage, (including abruptio placentae, placenta praevia, uterine atony, and retained products of conception, etc); 2) abortion, 3) hypertensive disorders in pregnancy (pre-eclampsia, eclampsia), 4) ruptured ectopic gestation, 5) ruptured uterus in labour, 6) amniotic fluid embolism, and 7) genital tract sepsis.
Results: There were 1,846 maternal deaths of which 86.4% were classified as direct maternal deaths (P<0.0001). The mean age was 28.72 ±6.47 years. The majority, 1,346 (84.4%) were coroner cases (p< 0.0001). Abortion (27.4%), hypertensive disorders in pregnancy
(27.3%), and obstetric haemorrhage (27.0%) were the common causes. There was a general declined in the trend of maternal deaths over the 20-year period, particularly those due to abortion, obstetric haemorrhage, ruptured tubal gestation and ruptured
uterus in labour. However, deaths due to hypertensive disorders in pregnancy showed a relative rise over the period.
Conclusion: Abortion, hypertensive disorders in pregnancy and obstetrics haemorrhage, were the major causes of maternal deaths. There was a general decline in the trend of maternal deaths over the study period.