Autopsy study on maternal deaths in Mulago hospital

Abstract

OBJECTIVES: To describe the anatomical pathological causes of maternal deaths, and establish their relationship with age and parity, in Mulago hospital. METHOD: The first 100 mothers, who died during pregnancy or within 42 days after termination of pregnancy irrespective of the cause of death from April 2005 to March 2006 inclusive, were consecutively entered into the study. I gave each cause a serial number for identification and all the gross findings documented on data entry forms (DEF) as seen in Appendix G. Samples were fixed in 10% formalin and taken to the department of pathology for histological processing and findings entered on DEF. Data from the study was cross-checked, edited and entered into computer using EPI-INFO 6.0 software for storage and analysis. RESULTS: The commonest anatomical pathological causes were direct, mainly ruptured uterus 20% and postabortal sepsis 18%. In fortuitous causes, pyogenic meningitis ranked highest with 12%, followed by cryptococcal meningitis and disseminated tuberculosis each 6%, and the only indirect cause, anaemia 6%. The ages ranged from 17-37 years, with a mean age of 25 years, and the parities ranged from zero to eight. The largest maternal deaths occurred in the 20-24 years age group, and one and two parties. This was a result of more mothers delivering in these categories. A tentative analysis indicated that approximately 90% of the maternal deaths could be classified as avoidable. However, results further showed that age and parity had no statistical significance in relation to causes of maternal morality. CONCLUSION: Other than age and parity, there should be other factors responsible for these predominantly preventable causes of maternal death.