Maternal mortality in a tertiary center after introduction of free antenatal care.
OBJECTIVE
Determination of maternal mortality rate (MMR) and the main causes of maternal death after the implementation of free antenatal care in a tertiary center in South Africa.


METHODS
Retrospective case study on maternal deaths from 1 January 1993 to 31 July 1997.


RESULTS
The maternal mortality rate was 128/100000 births. Hypertension disorders (18%), hemorrhage (18%) and sepsis (13%) were the most important causes of death; 44% of all deaths were considered preventable.


CONCLUSIONS
The high percentage (44%) of preventable deaths is a cause of concern and is the result of increased workload, decreased staff numbers and late referrals with low socio-economic class of the patient. The discrepancy in the mortality rate between patients booked at the tertiary institution (29.8/100000) and patients booked elsewhere (304.7/100000) or not booked at all (348.5/100000) indicates the need for improving antenatal care in the periphery.
Daponte
A
A
Department of Obstetrics and Gynecology, Johannesburg Hospital and University of the Witwatersrand Medical School, Parktown, South Africa.
Guidozzi
F
F
Marineanu
A
A
D000328:Adult; D017677:Age Distribution; D005260:Female; D017052:Hospital Mortality; D006779:Hospitals, Public / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011295:Prenatal Care / Q000191:economics; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D017664:Uncompensated Care