Maternal mortality following post-partum haemorrhage in Calabar a 6-year review

Abstract

During the 6-year period (January 1987 to December 1992) a maternal mortality rate of 16.2 per 1,000 deliveries and a post-partum haemorrhage case fatality rate of 2.2 percent were recorded at the University of Calabar Teaching Hospital. Sixteen of the 62 unbooked patients with primary post-partum haemorrhage died giving a case fatality rate of 25.8% as compared with a case fatality rate of 0.8% for booked patients with primary post-partum haemorrhage. A case fatality of 5.4% from induced labour compared with 1.8% from spontaneous labour was recorded, while assisted vaginal delivery had a case fatality rate of 4.7%. Uterine atony, retained placenta and coagulation defect in that order were the main causes of maternal death from primary post-partum haemorrhage. The case fatality rate amongst primigravidas now seems to be the same as that of grandmultipararas traditionally classified as high risk. Lack of adequate supervision of junior residents formed the major defect in the management of patients in this study.