PDF(Pubmed)
Abstract：
UNASSIGNED: Anecdotal evidence showed increased maternal deaths at the major tertiary hospital over the past two years (2020-2021). We reviewed the maternal death audit data, identified the main causes of maternal death, and associated risk factors. Findings were shared with policymakers to help reduce maternal mortality.
UNASSIGNED: We conducted a secondary data review and descriptive analysis of maternal death at the tertiary hospital located in Monrovia.
UNASSIGNED: The maternal death data were extracted from patient medical records, including death certificates and maternal audit records. The record of live births was obtained from the delivery register. Data were analyzed using Epi Info version 7.2 Maternal mortality ratio (MMR) was estimated, the leading direct and indirect causes of maternal death were identified, and the factors associated with maternal death were explored using logistic regression at a 5% level of significance.
UNASSIGNED: There are a total of 233 maternal deaths and 14, 879 live births giving a maternal mortality ratio (MMR) of 1565 per 100,000 live births during the period under review. The median age of the mothers at death was 29 (14-45) years. About 40.3% (94/233) of cases died within <1 day of admission, referrals accounted for 59% (137/233) of the cases. Direct causes of death accounted for 66% (147/223). Hemorrhage [30.6% (45/147)], Eclampsia [(30/147) 20.6%] and Sepsis [(30/147) 20.6%] were the main direct causes of death while cardiovascular-related [18.4% (14/76)] and HIV/AIDS [16% (12/76)] were the leading indirect cause of death. Patients from referred other facilities were 7.9 times more likely to die as compared to non-referral (pOR:7.9, 95%CI: 5.9-10.6, p < 0.001).
UNASSIGNED: The maternal mortality ratio remained high. Referrals were done late. The Liberia Ministry of Health should equip more secondary-level health facilities and tertiary hospitals to handle maternal emergencies and sensitize the populace and healthcare workers on prompt identification and referral of obstetric emergencies. The MoH also needs to improve the blood transfusion services to help in the management of postpartum hemorrhage.
UNASSIGNED: We conducted a secondary data review and descriptive analysis of maternal death at the tertiary hospital located in Monrovia.
UNASSIGNED: The maternal death data were extracted from patient medical records, including death certificates and maternal audit records. The record of live births was obtained from the delivery register. Data were analyzed using Epi Info version 7.2 Maternal mortality ratio (MMR) was estimated, the leading direct and indirect causes of maternal death were identified, and the factors associated with maternal death were explored using logistic regression at a 5% level of significance.
UNASSIGNED: There are a total of 233 maternal deaths and 14, 879 live births giving a maternal mortality ratio (MMR) of 1565 per 100,000 live births during the period under review. The median age of the mothers at death was 29 (14-45) years. About 40.3% (94/233) of cases died within <1 day of admission, referrals accounted for 59% (137/233) of the cases. Direct causes of death accounted for 66% (147/223). Hemorrhage [30.6% (45/147)], Eclampsia [(30/147) 20.6%] and Sepsis [(30/147) 20.6%] were the main direct causes of death while cardiovascular-related [18.4% (14/76)] and HIV/AIDS [16% (12/76)] were the leading indirect cause of death. Patients from referred other facilities were 7.9 times more likely to die as compared to non-referral (pOR:7.9, 95%CI: 5.9-10.6, p < 0.001).
UNASSIGNED: The maternal mortality ratio remained high. Referrals were done late. The Liberia Ministry of Health should equip more secondary-level health facilities and tertiary hospitals to handle maternal emergencies and sensitize the populace and healthcare workers on prompt identification and referral of obstetric emergencies. The MoH also needs to improve the blood transfusion services to help in the management of postpartum hemorrhage.
摘要：
■轶事证据显示，过去两年（2020-2021年），主要三级医院的孕产妇死亡人数增加。我们审查了孕产妇死亡审计数据，确定了孕产妇死亡的主要原因，和相关的危险因素。与决策者分享了调查结果，以帮助降低孕产妇死亡率。
■我们对位于蒙罗维亚的三级医院的孕产妇死亡进行了二级数据回顾和描述性分析。
■孕产妇死亡数据是从患者病历中提取的，包括死亡证明和产妇审计记录。活产的记录是从分娩登记册中获得的。使用EpiInfo7.2版对数据进行分析，估计产妇死亡率（MMR），确定了孕产妇死亡的主要直接和间接原因，并使用5％显著性水平的logistic回归分析了与孕产妇死亡相关的因素。
在本报告所述期间，共有233例孕产妇死亡和14,879例活产，孕产妇死亡率（MMR）为每100,000例活产1565例。死亡母亲的平均年龄为29岁（14-45岁）。约40.3%(94/233)的病例在入院后<1天内死亡，转诊占59%(137/233)。直接死因占66%(147/223)。出血[30.6%(45/147)]，子痫[(30/147)20.6%]和脓毒症[(30/147)20.6%]是主要的直接死亡原因,心血管相关[18.4%(14/76)]和HIV/AIDS[16%(12/76)]是主要的间接原因。与未转诊的患者相比，转诊的其他机构的患者死亡可能性高7.9倍（pOR：7.9，95CI：5.9-10.6，p<0.001）。
■孕产妇死亡率仍然很高。转介时间晚了。利比里亚卫生部应配备更多的二级保健设施和三级医院，以处理孕产妇紧急情况，并提高民众和医护人员对迅速识别和转诊产科紧急情况的敏感性。卫生部还需要改善输血服务，以帮助管理产后出血。
■我们对位于蒙罗维亚的三级医院的孕产妇死亡进行了二级数据回顾和描述性分析。
■孕产妇死亡数据是从患者病历中提取的，包括死亡证明和产妇审计记录。活产的记录是从分娩登记册中获得的。使用EpiInfo7.2版对数据进行分析，估计产妇死亡率（MMR），确定了孕产妇死亡的主要直接和间接原因，并使用5％显著性水平的logistic回归分析了与孕产妇死亡相关的因素。
在本报告所述期间，共有233例孕产妇死亡和14,879例活产，孕产妇死亡率（MMR）为每100,000例活产1565例。死亡母亲的平均年龄为29岁（14-45岁）。约40.3%(94/233)的病例在入院后<1天内死亡，转诊占59%(137/233)。直接死因占66%(147/223)。出血[30.6%(45/147)]，子痫[(30/147)20.6%]和脓毒症[(30/147)20.6%]是主要的直接死亡原因,心血管相关[18.4%(14/76)]和HIV/AIDS[16%(12/76)]是主要的间接原因。与未转诊的患者相比，转诊的其他机构的患者死亡可能性高7.9倍（pOR：7.9，95CI：5.9-10.6，p<0.001）。
■孕产妇死亡率仍然很高。转介时间晚了。利比里亚卫生部应配备更多的二级保健设施和三级医院，以处理孕产妇紧急情况，并提高民众和医护人员对迅速识别和转诊产科紧急情况的敏感性。卫生部还需要改善输血服务，以帮助管理产后出血。
