Kamga Danielle Victoire Tiako, Nana Philip Njotang, Fouelifack Florent Ymele, Fouedjio Jeanne Hortence
Centre Médical de la Garde Présidentielle de Yaoundé, Cameroun.
Hôpital Central de Yaoundé, Cameroun.
Pan Afr Med J. 2017 Aug 3;27:248. doi: 10.11604/pamj.2017.27.248.12942. eCollection 2017.
The World Health Organization (WHO) estimates that 585.000 women die every year in the world as a result of complications related to pregnancy, delivery, postpartum period and abortion (the latter contributing to 13% of maternal deaths). Ectopic pregnancies are responsible for 10% of maternal mortality in the first quarter of pregnancy. Maternal mortality rate is high in Cameroon, estimated at 782 per 100.000 live births according to EDS-MICS 2011. AS the role of these two conditions in maternal mortality is little documented in our country, we conducted this study to assess the role of abortions and ectopic pregnancies in maternal mortality rate in Cameroon.
We conducted a retrospective and analytic study. We collected data from all the medical records of pregnant patients and pregnant patients died before the 28week of pregnancy at three university hospitals: Central Hospital of Yaoundé (HCY), Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital (HGOPY), University Hospital (CHU), over a period of five years, from 1 June 2011 to 31 May 2016. Data were recorded on a pre-established and tested technical sheet, collected using CS Pro 6.2 software and analyzed using SPSS software 20. The statistical tests for comparison used were Khi 2 and Fischer test according to the effective sample. The threshold significance level was set at p <0.05.
We recorded 524 maternal deaths per 31116 live births, reflecting a maternal mortality rate (MMR) of 1538,9/100 000 live births. Out of 524 maternal deaths, 414 medical records were workable, including 100 (24.2%)abortions and 24 (5.8%) ectopic pregnancies. These 2 conditions contributed together to 30% of maternal deaths (124 medical records out of 414). The analysis of 124 medical records showed that the average age was 27.58 +/- 6 years, ranging from 18 to 48 years. The age group 20-24 years was the most represented (33.1%), followed by that 25-29 years (24.19%). The singles constituted 75%, housewives 36.7%, with level of secondary education in 62.5% and multigestes constituted 36.1% of our sample. 73.4% of patients didn't undergo any prenatal consultation and only 2.4% had undergone at least 4 consultations. Complications resulting in deaths were dominated by hemorrhage and infections.
Abortions and ectopic pregnancies are the major causes of maternal mortality in our country. We recommend strengthening of family planning to limit unwanted pregnancies and socio-economic support for patients at risk.
世界卫生组织（WHO）估计，全球每年有58.5万名妇女死于与妊娠、分娩、产后期及堕胎相关的并发症（后者占孕产妇死亡的13%）。异位妊娠导致妊娠第一季度孕产妇死亡率的10%。喀麦隆的孕产妇死亡率很高，根据2011年EDS - MICS数据，估计每10万例活产中有782例。由于我国关于这两种情况在孕产妇死亡中作用的记录很少，我们开展了本研究以评估堕胎和异位妊娠在喀麦隆孕产妇死亡率中的作用。
我们进行了一项回顾性分析研究。收集了喀麦隆雅温得中心医院（HCY）、雅温得妇产儿科医院（HGOPY）、大学医院（CHU）这三家大学医院在2011年6月1日至2016年5月31日这五年期间所有怀孕患者及妊娠28周前死亡的怀孕患者的病历数据。数据记录在预先设定并经过测试的技术表格上，使用CS Pro 6.2软件收集，并用SPSS软件20进行分析。根据有效样本，用于比较的统计检验采用卡方检验和费舍尔检验。显著性水平阈值设定为p<0.05。
我们记录到每31116例活产中有524例孕产妇死亡，反映出孕产妇死亡率（MMR）为1538.9/10万例活产。在524例孕产妇死亡中，414份病历可用，其中100例（24.2%）为堕胎，24例（5.8%）为异位妊娠。这两种情况共同导致了30%的孕产妇死亡（414份病历中的124份）。对124份病历的分析显示，平均年龄为27.58±6岁，范围在18至48岁之间。20 - 24岁年龄组占比最大（33.1%），其次是25 - 29岁年龄组（24.19%）。单身者占75%，家庭主妇占36.7%，62.5%具有中等教育水平，多产妇占样本的36.1%。73.4%的患者未进行任何产前检查，只有2.4%的患者至少进行了4次检查。导致死亡的并发症以出血和感染为主。
堕胎和异位妊娠是我国孕产妇死亡的主要原因。我们建议加强计划生育以减少意外怀孕，并为高危患者提供社会经济支持。
