title: Reducing maternal deaths in a low resource setting in Nigeria.
abstract: OBJECTIVE
  To assess the impact of the adoption of evidence based guidelines on maternal mortality reduction at Enugu State University Teaching Hospital, Nigeria.
  
  
  METHODS
  A retrospective review of all maternal deaths between 1 st January, 2005 and 31 st December, 2010 was carried out. Evidence based management guidelines for eclampsia and post-partum hemorrhage were adopted. These interventions strategy were carried out from 1 st January, 2008-31 st December, 2010 and the result compared with that before the interventions (2005-2007).
  
  
  METHODS
  Maternal mortality ratio (MMR) and case fatality rates.
  
  
  RESULTS
  There were 9150 live births and 59 maternal deaths during the study period, giving an MMR of 645/100 000 live births. Pregnant women who had no antenatal care had almost 10 times higher MMR. There was 43.5% reduction in the MMR with the interventions (488 vs. 864/100 000 live births P = 0.039, odds ratio = 1.77). There was also significant reduction in case fatality rate for both eclampsia (15.8% vs. 2.7%; P = 0.024, odds ratio = 5.84 and Post partum hemorrhage (PPH) (13.6% vs. 2.5% P value = 0.023, odds ratio = 5.5. Obstetric hemorrhage was the most common cause of death (23.73%), followed by the eclampsia.
  
  
  CONCLUSIONS
  Administration of evidence based intervention is possible in low resource settings and could contribute to a significant reduction in the maternal deaths.
authors: Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ittuku-Ozalla, Nigeria.
authors: E C
authors: EC
authors: Ezugwu
authors: P U
authors: PU
authors: Agu
authors: M O
authors: MO
authors: Nwoke
authors: F O
authors: FO
authors: Ezugwu
mesh_terms: D000328:Adult; D004461:Eclampsia / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006295:Health Resources / Q000191:economics*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D063130:Maternal Death / Q000517:prevention & control / Q000639:trends*; D008427:Maternal Health Services / Q000458:organization & administration*; D009549:Nigeria / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000401:mortality*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends