Factors associated with anaesthesia‐related maternal mortality in a tertiary hospital in Nigeria

Enohumah, Kingsley; Imarengiaye, CO

doi:10.1111/j.1399-6576.2006.00945.x

Cited by 46 publications

(30 citation statements)

References 14 publications

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“…This finding was consistent with findings from the studies of Owonikoko KM, et al [3], Menacker F, et al [21], Enohumah KO, et al [22]. Patients with abruptio placentae received more units of blood, in keeping with some studies which noted that abruptio placentae with blood loss is one of the causes of hemorrhage in pregnancy and can be life threatening [3,23].The majority of the transfused patients in this study received whole blood.…”

Section: Discussionsupporting

confidence: 82%

Obstetric Emergencies and Transfusion Needs in a Nigerian Hospital

Ts¹,

Bello²

2016

HTIJ

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IBlood transfusion plays a significant role as a life-saving practice in emergency obstetrics and it is one of the essential components of comprehensive emergency obstetric care yielding a reduction in maternal mortality. While transfusion is commonly used to combat anaemia in obstetric practice, the majority of patients receiving transfusion are given to otherwise healthy women in response to undiagnosed obstetric hemorrhage. This study explores the need and blood transfusion rate among obstetrics patients at the University College Hospital (UCH), Ibadan to provide insight into the rationale behind such practices. This is a retrospective study of transfused obstetrics patients at UCH between the year 2009 and 2014. Information was extracted from their medical records using a pro-forma. Data were entered and analysed using SPSS version 20.Of the 21,208 births and 27,019 antenatal admissions during the study period, 597 patients were transfused and 565 medical records were analysed. Among these 565 patients, about two-thirds 412 (72.9%) were un-booked patients. The transfusion rate was 2.2% and the commonest associated obstetrics complication requiring transfusion was anaemia (65.5%) while 184 (32.6%) were transfused because of postpartum hemorrhage. Other indications for transfusion were abruptio placentae, malaria and placenta previa. Patients who delivered via Caesarean Section (CS) had the highest transfusion rate of 62.4% and the estimated blood loss during delivery was significantly higher among the unbooked patients (P<0.01). More than two-thirds, 466 (82.5%) received whole blood while only 2 (0.4%) received cryoprecipitate. About one-third of patients received single unit-transfusions.Though the overall obstetric transfusion rate was lower than that of comparable facilities, the transfusion rate among patients receiving CS was markedly high. Additionally, the majority of transfused obstetric patients had complications resulting in anaemia, while hemorrhage propagated the second highest number of cases requiring transfusion.

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Section: Discussionsupporting

confidence: 82%

Obstetric Emergencies and Transfusion Needs in a Nigerian Hospital

Ts¹,

Bello²

2016

HTIJ

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“…Because of the role of anaesthesia as a cause of maternal mortality in the past, studies have been done on this important topic in sub-Saharan Africa including Nigeria (Okafor and Okezie 2005;Enohumah and Imarengiaye 2006;Imarengiaye et al 2001). This study was undertaken to investigate the changing trends of different forms of anaesthesia for caesarean section and on feto-maternal outcome following caesarean delivery in the University of Nigeria Teaching Hospital, Enugu.…”

Section: Introductionmentioning

confidence: 98%

Trends of different forms of anaesthesia for caesarean section in South-eastern Nigeria

Okafor¹,

Ezegwui

Ekwazi

2009

Journal of Obstetrics and Gynaecology

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General anaesthesia is recognised as a cause of maternal mortality/morbidity in caesarean deliveries, and regional anaesthesia is believed to reduce anaesthesia-related maternal/fetal morbidity and mortality. The aim of this study is to present the trends of different forms of anaesthesia for caesarean section in Eastern Nigeria. We conducted a retrospective survey of hospital records of caesarean deliveries in this unit over a 4-year period from January 2003 to December 2006. There were 2,968 deliveries and 3,140 births (2,959 live births), with 729 women (24%) delivered by caesarean section. There was a yearly increase in the use of regional anaesthesia from 18% in 2003 to 48% in 2004 and 72.6% in 2005, but it fell to 71% in 2006. There were 59 stillbirths giving a stillbirth rate of 81/1,000 caesarean deliveries. The total number of stillbirths in the hospital during the study period was 179 giving a stillbirth rate of 60/1,000 deliveries. A total of 42 (71%) stillbirth deliveries were associated with general anaesthesia and 17 (29%) associated with spinal anaesthesia. Of the 32 neonates with an Apgar score of 3-5 at 5 min after birth, 21 (66%) delivered under general anaesthesia and 11 (34%) delivered under spinal anaesthesia. There were eight hysterectomies in patients with ruptured uterus, all under general anaesthesia. There was one maternal death in a patient who was delivered under general anaesthesia. The fetal loss in this study is high and may indicate that most data on stillbirths from parts of the developing world may be underestimates. In conclusion, in developing country such as Nigeria there is a changing trend towards the use of regional anaesthesia during caesarean section. Its use should be encouraged in the developing world, especially resource-poor environments because it is cheaper to provide.

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“…[1][2][3] General anaesthesia for caesarean section appears to be associated with higher rates of serious and life-threatening complications than regional anaesthesia 3,4 and most anaesthetic-related maternal deaths still result from complications of airway management during general anaesthesia. [5][6][7] Nevertheless a number of indications for general anaesthesia remain, but the declining use of general anaesthesia in the obstetric population has raised concern that safety standards may be compromised as a result of inadequate exposure to this technique and insufficient training in airway management for the pregnant woman. 8 Furthermore, the demographic of the obstetric population is changing in many countries, with the average age and weight of women giving birth rising and the medical complexity of cases increasing.…”

Section: Introductionmentioning

confidence: 99%