title: [Maternal mortality in the maternity ward of Befelatanana. University Hospital of Antananarivo].
abstract: OBJECTIVE
  A retrospective study was conducted to assess mortality rates at the Befelatanana Women's Hospital from January 1st 1988 through December 31st 1997, define trends, study causes and identify problems encountered during treatment and those related to the referral system, in order to improve prevention and patient management
  
  
  METHODS
  and method. Birth and death registries, operation reports and patient charts were analyzed. All maternal deaths wether of direct or indirect obstetrical origin were considered.
  
  
  RESULTS
  There were 997 cases of maternal death among 91, 032 births, i.e. 1.09% or 1,245 maternal deaths per 100,000 live births. Among direct obstetrical causes of death (93%), 65.8% involved infectious complications and 22.9% renal and vascular complications.Other causes were anesthesia accidents and thrombolic events. Among the direct obstetrical causes, complicated delivery was responsible for 57.4% of the deaths and 42.6% of the abortions. Indirect obstetrical causes were due to malaria (68.6%), heart disease (21.4%) and asthma (10%).
  
  
  CONCLUSIONS
  This high rate of maternal death illustrates the serious situation of obstetrics in our region. Our aim is to reduce this rate by promoting the Birth Place Without Risk program and improving management conditions. Implementation of this ambitious program requires implication of political decisions makers convinced of the importance of improving women's conditions and the health care system in Madagascar.
authors.affiliation: Maternité de Befelatanana, Centre Hospitalier Universitaire d'Antananarivo, BP 8394 Antananarivo/101 Madagascar. ecar.cem@vitelcom.mg
authors.forename: C L
authors.initials: CL
authors.lastname: Andriamady Rasoarimahandry
authors.forename: M
authors.initials: M
authors.lastname: Rakotoarimanana
authors.forename: R J
authors.initials: RJ
authors.lastname: Ranjalahy
mesh_terms: D001249:Asthma / Q000150:complications; D002423:Cause of Death; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006785:Hospitals, University; D006801:Humans; D007239:Infections / Q000401:mortality; D008270:Madagascar; D008288:Malaria / Q000150:complications; D008428:Maternal Mortality; D007744:Obstetric Labor Complications; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies