METHODS: This was a 10 year retrospective study using readily available data from the maternity registers. The International Classification of Diseases-Maternal Mortality (ICD-MM) coding system for maternal deaths was used.
RESULTS: The maternal mortality ratio (MMR) declined from 655 per 100,000 live births in 2011 to 203 per 100,000 live births by 2020. The commonest groups of maternal mortality during the period 2011-2020 were hypertensive disorders, obstetric haemorrhage, pregnancy-related infection, and pregnancies with abortive outcomes. There were 273 maternal deaths recorded in the period 2011-2015, and 168 maternal deaths in the period 2016-2020. There was also a decline in maternal deaths due to obstetric haemorrhage (53 vs. 34). Maternal deaths due to pregnancy-related infection also declined (46 vs. 22), as well as pregnancies with abortive outcomes (40 vs. 26).
CONCLUSIONS: There was a 69% decline in the MMR over the 10 year period. The introduction of government interventions such as malarial control, the adoption of life-long Option B+ antiretroviral treatment for the pregnant women, the training courses of staff, and the introduction of strong clinical leadership and accountability were all associated with a significant decline in the causes of maternal deaths.
方法:这是一项为期10年的回顾性研究,使用了来自产妇登记的现成数据。使用国际疾病分类-孕产妇死亡率(ICD-MM)编码系统来处理孕产妇死亡。
结果:孕产妇死亡率(MMR)从2011年的每100,000活产655下降到2020年的每100,000活产203。2011-2020年期间最常见的孕产妇死亡群体是高血压疾病,产科出血,妊娠相关感染,和流产结果的怀孕。2011-2015年期间有273例产妇死亡,2016-2020年期间有168例产妇死亡。产科出血导致的孕产妇死亡也有所下降(53vs.34).与妊娠相关的感染导致的孕产妇死亡也有所下降(46vs.22),以及流产结果的怀孕(40vs.26).
结论:在过去的10年中,MMR下降了69%。引入疟疾控制等政府干预措施,对孕妇采用终身选项B+抗逆转录病毒治疗,员工培训课程,以及强有力的临床领导和问责制的引入都与孕产妇死亡原因的显著下降有关.