title: Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicentre hospital-based study.
abstract: OBJECTIVE
  To assess the maternal mortality ratio in maternity units of reference hospitals in large west African cities, and to describe the distribution of complications and causes of maternal deaths.
  
  
  METHODS
  Prospective descriptive study in twelve reference maternities located in three African countries (Benin, Ivory Coast, Senegal). Data (clinical findings at hospital entry, medical history, complications, type of surgery, vital status of the women at discharge) were collected from obstetrical and surgical files and from admission hospital registers. All cases of maternal deaths were systematically reviewed by African and European staff.
  
  
  RESULTS
  Of a total of 10,515 women, 1495 presented a major obstetric complication with dystocia or inappropriate management of the labour phase as the leading cause. Eighty-five maternal deaths were reported, giving a global hospital-based maternal mortality ratio of 800/100,000. Hypertensive disorders were involved in 25/85 cases (29%) and post-partum haemorrhage in 13/85 cases (15%). Relatively few cases (14) of major sepsis were reported, leading to three maternal deaths.
  
  
  CONCLUSIONS
  The results of this multicentre study confirm the high rates of maternal mortality in maternity units of reference hospitals in large African cities, and in addition to dystocia the contribution of hypertensive disorders and post-partum haemorrhage to maternal deaths.
authors.affiliation: Human Fertility Research Group, INSERM, Paul Sabatier University, Paule de Viguier Hospital, Toulouse, France. thonneau.p@chu-toulouse.fr
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Thonneau
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsudai
authors.forename: Eusèbe
authors.initials: E
authors.lastname: Alihonou
authors.forename: Jose
authors.initials: J
authors.lastname: De Souza
authors.forename: Ousseynou
authors.initials: O
authors.lastname: Faye
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Moreau
authors.forename: Yao
authors.initials: Y
authors.lastname: Djanhan
authors.forename: Christiane
authors.initials: C
authors.lastname: Welffens-Ekra
authors.forename: Nathalie
authors.initials: N
authors.lastname: Goyaux
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D001541:Benin / Q000453:epidemiology; D002423:Cause of Death; D007560:Cote d'Ivoire / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000401:mortality*; D005260:Female; D006761:Hospitals; D006801:Humans; D006973:Hypertension / Q000401:mortality; D008428:Maternal Mortality; D007744:Obstetric Labor Complications / Q000401:mortality; D006473:Postpartum Hemorrhage / Q000401:mortality; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D012675:Senegal / Q000453:epidemiology