title: Autopsy-certified maternal mortality at Ile-Ife, Nigeria.
abstract: OBJECTIVE
  Maternal mortality is a major health problem, especially in Nigeria, where accurate autopsy-based data on the prevalent causes are not readily available. The aim of this study was therefore to accurately determine the causes of maternal death as seen in a tertiary health facility in Nigeria.
  
  
  METHODS
  This was a descriptive, retrospective review of the postmortem autopsy findings from cases of maternal death at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria over a 5-year period. Analyses were performed for differences in proportions using PEPI computer programs for epidemiologists (P is significant at <0.05).
  
  
  RESULTS
  A total of 84 cases of maternal deaths were used for the study. Approximately 71.4% of the maternal deaths were due to direct causes and 28.6% were due to indirect causes. The mean age at the time of death was 27.9±7.5 years. Overall, the three leading causes of death were obstetric hemorrhage (30.9%), complications of abortion (23.8%), and nongenital (nonobstetric) infections (14.2%). Of the direct causes of maternal death, obstetric hemorrhage (43.3%) was the leading cause, with postpartum hemorrhage accounting for most (65.0%) of such deaths; other causes included complications of unsafe induced abortion (33.3%) and of labor (11.7%). Of the indirect causes, nongenital infections (50.0%), anemia (25.0%), and preexisting hypertension (20.8%) accounted for the majority of the maternal deaths. There was disparity between the clinical and autopsy diagnoses in 34 of the 84 cases (38.1%).
  
  
  CONCLUSIONS
  The leading causes of maternal death in this study are similar to those in other developing countries. Autopsy is an invaluable tool in accurately determining the cause of maternal death.
authors.affiliation: Department of Anatomic Pathology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria.
authors.forename: Amatare
authors.initials: A
authors.lastname: Dinyain
authors.affiliation: Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: G Olutoyin
authors.initials: GO
authors.lastname: Omoniyi-Esan
authors.affiliation: Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
authors.forename: Olaejirinde O
authors.initials: OO
authors.lastname: Olaofe
authors.affiliation: Department of Morbid Anatomy and Histopathology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
authors.forename: Donatus
authors.initials: D
authors.lastname: Sabageh
authors.affiliation: Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Akinwumi O
authors.initials: AO
authors.lastname: Komolafe
authors.affiliation: Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Olusegun S
authors.initials: OS
authors.lastname: Ojo
keywords: Nigeria; autopsy; causes; maternal mortality