title: Post natal maternal morbidity patterns in mothers delivering in Gweru City (Midlands province).
abstract: OBJECTIVE
  To determine morbid conditions suffered by mothers during the first six weeks post delivery and risk factors associated with them in Gweru district.
  
  
  METHODS
  A cross sectional survey.
  
  
  METHODS
  Gweru district hospital, Monomotapa, Mkoba 1 and Mkoba polyclinic.
  
  
  METHODS
  A consecutive sample of 201 mothers residing in Gweru district who delivered in these facilities during the month of June 1997.
  
  
  METHODS
  Morbid conditions, magnitude and the risk factors.
  
  
  RESULTS
  During follow up checks on recruited mothers, turn up rates were 82% and 63% at two and six weeks respectively. Fifty eight percent (58%) of the mothers reported at least one morbid condition within the first 24 hours post delivery and pain was a dominant feature. At two weeks, 56% of those who turned up predominantly presented with sepsis in areas of the reproductive tract. The figure fell to 35% among mothers who turned up at six weeks and a mixture of pain and sepsis were the predominant complaints. Episiotomies caused a lot of pain post operatively and the risk of subsequent sepsis was high, (OR: 9; 95% CI: 1.16 < OR < 69.7; p = 0.020). Statistically significant associations were found between backache and multiparity (OR: 1.89; 95% CI: 1 < OR < 3.4; p = 0.040) and also between Caesarian section and some morbid conditions (OR: 4.14; p = 0.002; 95% CI 2.05 < OR < 10.91). The prevalence rate of HIV was 29.4%. HIV positivity was associated with marriage below the age of 19 years (OR: 2.4; 95% CI 1.21 < OR < 3.8; p = 0.024). There was no association between HIV serostatus and maternal morbidity. Use of traditional medication during pregnancy was reported by 42% of mothers, but it did not have any immediately observable intrapartum of post partum effects. Similarly the place of delivery was not associated with post natal maternal morbidity.
  
  
  CONCLUSIONS
  The first two weeks post delivery were the most critical for the mother in terms of post natal maternal morbidity. Sepsis associated pain was the predominant condition. To improve the effectiveness of post natal care, a review within the first two weeks post delivery is an essential intervention, in addition to the routine six weeks check.
authors.affiliation: Ministry of Health and Child Welfare, Harare, Zimbabwe.
authors.forename: C
authors.initials: C
authors.lastname: Zishiri
authors.forename: L K
authors.initials: LK
authors.lastname: Shodu
authors.forename: M
authors.initials: M
authors.lastname: Tshimanga
authors.forename: L
authors.initials: L
authors.lastname: Nyirongo
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D015528:HIV Seroprevalence; D006801:Humans; D009017:Morbidity; D010298:Parity; D011159:Population Surveillance; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D015030:Zimbabwe / Q000453:epidemiology