Abstract

PIP: A study was undertaken of the incidence of maternal and child mortality during 1977 at the Kenyatta National Hospital in Kenya. It was noted that, while obstetric emergency referrals to the hospital from district and provincial hospitals in the country accounted for 3% of the total Kenyatta Hospital deliveries, they constituted 59% of the total maternal mortality cases. A table presents the reasons for obstetric referral. More than 1/3 of these were due to obstructed labor. Of the 10 deaths which occurred among the referral patients, 7 were due to puerperal sepsis and 1 each were due to thrombosis, severe anemia and heart failure, and ruptured uterus. In 41% of the referral cases, the patients were at fault, i.e., they had neglected to attend the antenatal clinic. The other 59% were due to hospital negligence. Of the babies born to these referral cases, approximately 60% were either born in poor condition or died at birth. Health education to publicize the antenatal clinics is recommended. Furthermore, it is felt that outlying hospitals should be well staffed and equipped to handle all obstetric emergencies.