Facility Based Maternal and Perinatal Mortality: Evidence from Maternal and Perinatal Death Surveillance and Response, Gombe State, Nigeria

Abstract

Background: Globally, women and their unborn babies continue to die from preventable causes. This study aims to highlight the causes of maternal and perinatal deaths and bring to the fore areas that need to be improved in order to improve maternal and perinatal health indices in Gombe State. Methodology: Information for this report was obtained from Maternal and Perinatal Deaths Surveillance and Response (MPDSR) desk officers and chairmen across MPDSR supported health facilities in the state. Secondary data abstraction from registers was conducted using an electronic questionnaire and was analysed using SPSS version 23. Findings: The Maternal Mortality Ratio (MMR) was 1,092/100,000 livebirths in 2019 and 993/100,000 live births in 2020. Majority of the women (84.3% and 86.7% in 2019 and 2020 respectively) were severely ill at presentation, while most maternal deaths were as a result of eclampsia/pre-eclampsia and Post Partum Haemorrhage (PPH). Only 15.9% and 14.4% of maternal deaths in 2019 and 2020 respectively were reviewed. Perinatal asphyxia accounted for 36.4% and 31.8% of perinatal deaths in 2019 and 2020 respectively, while prematurity resulted in 24.7% and 35.6% of deaths in 2019 and 2020 respectively. The Perinatal Mortality Rates (PMR) were 78.3/1000 births in 2019 and 76.1/1000 births in 2020. Conclusion: Although MMR and PMR have been on a decline in Gombe state from 2018 till date, these figures are still far from achieving the SDG 2030 target. There is therefore the need to revive MPDSR activities in the state and improve emergency obstetric health care services.

Evaluation of maternal and perinatal mortality in Amachara general hospital, Umuahia south local Government Area (LGA), Abia State, Nigeria, 2014 – 2017

“…In 2013, Nigeria had shown and upward trend in MMR, 545 deaths per 100,000 live births in 2008, 576 deaths per 100,000 live births in 2013 and 814 deaths per 100,000 live births in 2018 [30,31]. Although a slight downward trend was observed in 2017 in this study, 532.3 per 100,000 per live births was still unacceptably high and worse than in the figure obtained from Gombe State [32] where 342 per 100,000 live births was observed in 2000 to 211 deaths per 100,000 live births in 2017 [33]. The downward trend in MMR observed in Gombe State is in keeping with worldwide trend showing a 38% reduction in MMR from the figure of 2000 to that of 2017.…”

Prevalence And Outcomes Of Eclampsia At Federal Teaching Hospital Gombe, Nigeria

“…19,22 The case fatality of 2.4% is much lower than what was reported in other studies. 2,6,14 Two maternal deaths were recorded in two patients who had caesarean section, with clinical evidence of aspiration pneumonitis which may have resulted from aspiration of gastric contents or force feeding with concoctions at home. This preventable complication can be avoided in the hospital with proper nursing care of the unconscious patient, use of non-particulate antacids and Histamine (H2) receptor blockers prior to surgery and use of a nasogastric tube to decompress the stomach.…”

“…Eclampsia is responsible for about 30% of maternal mortality in Nigeria. 2 The MMR in Gombe is 993/100,000, 6 and Eclampsia contributes significantly to these astounding statistics. Adverse outcomes, including death from Eclampsia, are more likely in women at the extreme of ages, early onset preeclampsia, medical co-morbidities, low platelet count, having 10 or more convulsions, fever and primigravidas.…”

Predictors of health workers’ knowledge of maternal and perinatal deaths surveillance and response system in Morogoro region, Tanzania: An analytical cross-sectional study

“…[ 2 ] Intense national, regional, and global efforts, supported by various partners/stakeholders, have led to significant progress in reducing maternal and newborn morbidity and mortality rates. [ 3 ]…”