Maternal mortality in Syria: causes, contributing factors and preventability.
OBJECTIVE
To describe the biomedical and other causes of maternal death in Syria and to assess their preventability.


METHODS
A reproductive age mortality study (RAMOS) design was used to identify pregnancy related deaths. All deaths among women aged 15-49 reported to the national civil register for 2003 were investigated through home interviews. Verbal autopsies were used to ascertain the cause of death among pregnancy related maternal deaths, and causes and preventability of deaths were assessed by a panel of doctors.


RESULTS
A total of 129 maternal deaths were identified and reviewed. Direct medical causes accounted for 88%, and haemorrhage was the main cause of death (65%). Sixty nine deaths (54%) occurred during labour or delivery. Poor clinical skills and lack of clinical competency were behind 54% of maternal deaths. Ninety one percent of maternal deaths were preventable.


CONCLUSIONS
The causes of maternal death in Syria and their contributing factors reflect serious defects in the quality of maternal care that need to be urgently rectified.
Bashour
Hyam
H
Department of Family and Community Medicine, Faculty of Medicine, Damascus University, Damascus, Syria. hbashour@scs-net.org
Abdulsalam
Asmaa
A
Jabr
Aisha
A
Cheikha
Salah
S
Tabbaa
Mohammed
M
Lahham
Moataz
M
Dihman
Reem
R
Khadra
Mazen
M
Campbell
Oona M R
OM
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002983:Clinical Competence / Q000592:standards*; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008428:Maternal Mortality; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000401:mortality* / Q000517:prevention & control; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013593:Syria; D055815:Young Adult