Department of Obstetrics and Gynaecology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria.
Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Nigeria.
Afr J Reprod Health. 2020 Jun;24(2):115-122. doi: 10.29063/ajrh2020/v24i2.11.
Maternal morbidities are precursors to maternal mortality as well as potential causes of life time disability and poor quality of life. This study aimed to determine the pattern and spectrum of life-threatening maternal morbidities seen in tertiary reproductive health facilities in Nigeria. All cases of severe maternal outcome (SMO), maternal near-misses (MNM), or maternal death (MD), attending 42 tertiary hospitals across all geopolitical zones of Nigeria were prospectively identified using the WHO criteria over a period of 14 months. The main outcome measures were the incidence and outcome of severe maternal outcome by geopolitical regions of Nigeria. The participating hospitals recorded a total of 4383 severe maternal outcomes out of which were 3285 maternal near-misses and 998 maternal deaths. The proportion of maternal near-miss was similar across all the geopolitical zones but the maternal mortality ratio was highest in the southwestern zone (1,552) and least in the northcentral zone (750) of the country. Haemorrhage was the leading cause of severe maternal morbidities followed by hypertensive disorders of pregnancy. The mortality index of about 41% using the organ dysfunction criterion was triple the figures from other parts of the world. The findings reflect poor obstetric care in the tertiary hospitals in Nigeria. The health facilities in the country urgently need to be revamped.
孕产妇病况是孕产妇死亡率的前兆，也是终生残疾和生活质量下降的潜在原因。本研究旨在确定在尼日利亚三级生殖保健机构中危及生命的孕产妇病况的模式和范围。在 14 个月的时间内，使用世界卫生组织的标准，前瞻性地确定了所有在尼日利亚所有地缘政治区域的 42 家三级医院出现的严重孕产妇结局（SMO）、孕产妇接近死亡（MNM）或孕产妇死亡（MD）病例。主要观察指标为按尼日利亚地缘政治区域划分的严重孕产妇结局的发生率和结局。参与医院共记录了 4383 例严重孕产妇结局，其中 3285 例为孕产妇接近死亡，998 例为孕产妇死亡。所有地缘政治区域的孕产妇接近死亡比例相似，但该国西南部地区（1552 例）的孕产妇死亡率最高，而中北部地区（750 例）最低。出血是严重孕产妇病况的主要原因，其次是妊娠高血压疾病。根据器官功能障碍标准，死亡率指数约为 41%，是世界其他地区的三倍。这些发现反映了尼日利亚三级医院产科护理水平较差。该国的卫生机构急需进行改革。
