Juma E A, Odiyo F N
Department of Obstetrics and Gynaecology, Rift Valley Provincial General Hospital, P.O. Box 71, Nakuru, Kenya.
East Afr Med J. 2000 Jul;77(7):382-5.
To evaluate the factors that led to maternal mortality over a five-year period at the Rift Valley Provincial General Hospital, Nakuru.
A retrospective survey based on secondary data.
Department of Obstetrics and Gynaecology, Rift Valley Provincial General Hospital, Nakuru, between 1994 and 1998.
Evaluation of 109 deaths where records were available.
The average maternal mortality was 3.16/1000 live births. Twenty eight (26%) occurred in teenagers. Sixty two deaths (58%) accounted for those aged (14-24 years). Thirty four per cent of sixty two deaths occurred in nulliparous and primiparous patients. The commonest cause of death was haemorrhage and ruptured uterus (44%). Most deaths (53%) occurred within 24 hours of admission. Of these, 36 (62%) came directly from home in labour or ill or where deliveries were being attempted by non-medical persons.
Most of the deaths evaluated were preventable. Management of the major causes of death include blood (haemorrhage and ruptured uteri) transfusion. With poor blood transfusion services and the risk of HIV, this calls for alternatives to direct blood transfusion. Referral systems need to be overhauled and referring health institutions should get properly staffed. Despite good antenatal clinic attendance and availability of resources most patients still deliver at home.
评估导致纳库鲁裂谷省总医院五年间孕产妇死亡的因素。
基于二手数据的回顾性调查。
1994年至1998年间，纳库鲁裂谷省总医院妇产科。
对有记录的109例死亡病例进行评估。
孕产妇平均死亡率为3.16/1000活产。28例（26%）发生在青少年。62例死亡（58%）为年龄在14至24岁的产妇。62例死亡中有34%发生在未产妇和初产妇。最常见的死亡原因是出血和子宫破裂（44%）。大多数死亡（53%）发生在入院后24小时内。其中，36例（62%）直接从家中临产而来，或处于患病状态，或由非医务人员尝试接生。
评估的大多数死亡是可预防的。主要死因的管理包括输血（出血和子宫破裂）。鉴于输血服务不佳以及感染艾滋病毒的风险，这需要直接输血的替代方法。转诊系统需要彻底改革，转诊医疗机构应配备适当人员。尽管产前检查就诊率高且资源可得，但大多数患者仍在家中分娩。
