Millennium development goal 5: a review of maternal mortality at the Kenyatta National Hospital, Nairobi

Oyieke, Jennifer; Obore, Susan; Kigondu, Christine

doi:10.4314/eamj.v83i1.9345

Cited by 21 publications

(21 citation statements)

References 5 publications

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“…This was in agreement with findings in the study in Kenyatta National Hospital [10]. The highest proportion of mothers had attended two antenatal visits or less with slightly more having attended two visits and a fifth having not attended any visit.…”

Section: Discussionsupporting

confidence: 92%

“…This is consistent with the findings from a study in Moi Teaching and Referral hospital where a retrospective audit of 150 maternal deaths that had been recorded from 2004 to 2011 revealed that majority of the deaths had occurred in women between 25 and 34 years [9]. Similarly, a study at Kenyatta National Hospital among 253 maternal deaths found two-thirds of the women to have been between 25 and 35 years of age [10]. The study by Juma et al, 2000, revealed that the deaths were mainly from the 14 to 24 years age group.…”

Section: Discussionsupporting

confidence: 87%

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Maternal Mortality in Central Province, Kenya, 2009-2010

Muchemi¹,

Gichogo²

2014

Pan Afr Med J

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IntroductionMaternal mortality for Kenya was 488/100,000 live births in 2009. Maternal mortality estimate for Central Province is unknown. We retrospectively reviewed data between 1st July 2009 and 30th June 2010 to estimate the hospital based maternal mortality ratio, characterize deaths by time, place and person and describe possible causes of deaths in Central province, Kenya.MethodsWe abstracted data using a standard form from maternal death notification and review forms and the district reproductive health reports. Data was entered and analyzed using Microsoft Excel.ResultsThere were 89,512 live births and 111 deaths. The facility-based maternal mortality ratio was 124/100,000 live births. Seventy-three (66%) deaths had been audited. Thirty seven (33%) were aged 25 to 34 years. The mean age was 31years (±6). Thirty seven (33%) had a parity of less or equal to 2. Most case deaths (19%, n = 21) had attended 2 or less antenatal visits. The main gestation was below 37 weeks with 48% (n = 53). The main mode of delivery was vaginal (26%, n = 29). Majority (35%, n = 32) case deaths had delivered a live birth. Thirty seven (33%) mothers had been stable on admission. The main reason for admission waslabor with 12% (n = 13). Thirty-eight (34%) died within 24 hours after admission. Majority (27%, n = 30) were admitted antepartum but 39% (n = 43) were postpartum at the time of death. Thirty-five (32%) died of hemorrhage and 8(7%) Eclampsia.ConclusionMaternal mortality is of public health importance in the region. Most deaths occurred within 24 hours after admission. Third delay was important. Bleeding and Eclampsia were the main causes of death. A third (34%) of notified deaths were not reviewed.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Maternal Mortality in Central Province, Kenya, 2009-2010

Muchemi¹,

Gichogo²

2014

Pan Afr Med J

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“…Most cesarean section are performed as emergency procedures with an elective rate of less than 4%. [6][7][8][9] The advantage of placing a subcutaneous drain to drain any blood or serous fluid that may accumulate in the subcutaneous space, which cause post-operative pain or provide a good medium for microbial growth and infection. 10 Some surgeons, however, have raised much argument about the value of subcutaneous drains.…”

Section: Introductionmentioning

confidence: 99%

A clinical study to compare drain versus no drain in post cesarean section

Bindal

Munda

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Cesarean section is one of the commonest hospital based surgical procedure in obstetric mainly done to facilitate delivery in case where vaginal delivery is either not feasible or poses undue risk to mother, baby or both. The most common complications of CS are superficial surgical site complications including sepsis, seroma formation and breakdown.Methods: A prospective study done on 100 patients admitted in labour room of Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R.M.C., Gwalior between November 2015 to March 2016. Study divided into two groups: group I, including women who had no subcutaneous drain left and group II, including women who had a subcutaneous drain left before closure of the skin; Each group has 50 patients. The study included term pregnant women with pre-operative Hb >9 gm%, BMI >30 kg/m2 and were taken for emergency cesarean sections (for cephaloppelvic disproportion, fetal distress, abnormal presentations) with no intraoperative complications (hemorrhage, blood transfusion).Results: VAS median grade in patients without drain was G3 (46%), followed by G2 (28%), G4 (14%). VAS median grade in with drain group was G2 (68%), followed by G1 (24%) and then G3 (08%). Wound infection was noted in 4 (08%) patients in both the groups. Both groups were administered same group of intravenous antibiotics for 5 days. The mean hospital stay in patients without drain were 9.4 days and patients with drain were 8.2 days. The mean haemoglobin in patient with drain was 8.6 gm% and patients without drain was 9.4 gm%. Wound seroma in 13 cases and superficial breakdown in 4 cases in non-drain group versus 5 cases and 2 cases in drain group respectively. There is significant difference in postoperative pain and non-significant difference in postoperative fever.Conclusions: Patients in with drain group have reduced rates of wound seroma, postoperative pain, shorter hospital stay, but there is insignificant benefit regarding post-operative fever, superficial SSI, wound breakdown and hemoglobin concentration.

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“…The ratios are higher for the major teaching and referral hospitals where obstetrics complications are concentrated. For example, the MMR in Kenya’s largest referral hospital, Kenyatta National Hospital (KNH), was 922 per 100,000 live births in 2004 [8]. In Kilifi District Hospital in Kenya, the MMR was 250 per 100,000 live births between 2008 and 2010 [9].…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya

et al. 2013

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ObjectiveTo measure the incidence of maternal and early neonatal mortality in women who gave birth at Moi Teaching and Referral Hospital (MTRH) in Kenya and describe clinical and other characteristics and circumstances associated with maternal and neonatal deaths following deliveries at MTRH.MethodsA retrospective audit of maternal and neonatal records was conducted with detailed analysis of the most recent 150 maternal deaths and 200 neonatal deaths. Maternal mortality ratios and early neonatal mortality rates were calculated for each year from January 2004 to December 2011.ResultsBetween 2004 and 2011, the overall maternal mortality ratio was 426 per 100,000 live births and the early neonatal mortality rate (<7 days) was 68 per 1000 live births. The Hospital record audit showed that half (51%) of the neonatal mortalities were for young mothers (15–24 years) and 64% of maternal deaths were in women between 25 and 45 years. Most maternal and early neonatal deaths occurred in multiparous women, in referred admissions, when the gestational age was under 37 weeks and in latent stage of labour. Indirect complications accounted for the majority of deaths. Where there were direct obstetric complications associated with the delivery, the leading cause of maternal death was eclampsia and the leading cause of early neonatal death was pre-mature rupture of membranes. Pre-term birth and asphyxia were leading causes of early neonatal deaths. In both sets of records the majority of deliveries were vaginal and performed by midwives.ConclusionThis study provides important information about maternal and early neonatal mortality in Kenya’s second largest tertiary hospital. A range of socio demographic, clinical and health system factors are identified as possible contributors to Kenya’s poor progress towards reducing maternal and early neonatal mortality.

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Millennium development goal 5: a review of maternal mortality at the Kenyatta National Hospital, Nairobi

Cited by 21 publications

References 5 publications

Maternal Mortality in Central Province, Kenya, 2009-2010

Maternal Mortality in Central Province, Kenya, 2009-2010

A clinical study to compare drain versus no drain in post cesarean section

A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya

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