title: [Maternal mortality in Libreville, Gabon: assessment and challenges].
abstract: OBJECTIVE
  To analyze the course over time of the rates and causes of maternal mortality in Libreville, Gabon.
  
  
  METHODS
  This prospective descriptive study covers the 6-year period from January 1, 2001, to December 31, 2006. It was performed at the Libreville Hospital Center (LCH) maternity ward, the leading obstetrical care facility in the country. A maternal mortality registry began recording deaths on January 1, 2001. All maternal deaths are listed there, and a department meeting focusing on the death is organized after each. In this study, we analysed the epidemiologic characteristics, circumstances and cause of each death.
  
  
  RESULTS
  In all, 136 women died. Their mean age was 25 +/- 5 years with a range of 16 to 41 years. Mean parity was 4 +/- 3, and ranged from 1 to 7. Most of the women were not employed (86%), but had at least some secondary schooling (88%). There were 126 cases (93%) of intrapartum deaths. They occurred more often at night (72% versus 28% during the day) and during the week (77% versus 23% on weekends). The maternal mortality rate was cut in half between 2000 and 2006 (p<0.005), dropping from 444 to 248 per 100 000 live births. Hemorrhages and eclampsia were the two principal causes of mortality.
  
  
  CONCLUSIONS
  Faster access to care and improvement in the quality of emergency obstetrical care are essential conditions for reducing maternal mortality.
authors.affiliation: Maternité du centre hospitalier de Libreville (CHL), BP 2758 Libreville, Gabon. smayi3@yahoo.fr
authors.forename: Sosthène
authors.initials: S
authors.lastname: Mayi-Tsonga
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ndombi
authors.forename: Litochenko
authors.initials: L
authors.lastname: Oksana
authors.forename: Marcel
authors.initials: M
authors.lastname: Methogo
authors.forename: Thierno
authors.initials: T
authors.lastname: Diallo
authors.forename: Gabriel
authors.initials: G
authors.lastname: Mendome
authors.forename: Mathieu
authors.initials: M
authors.lastname: Mounanga
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*; D011446:Prospective Studies; D055815:Young Adult