Levels and causes of maternal mortality in Senegal

Kodio, B.; Bernis, Luc de; Bâ, Mariame Guèye; Ronsmans, Carine; Pison, Gilles; Etard, Jean‐François

doi:10.1046/j.1365-3156.2002.00892.x

Cited by 35 publications

(28 citation statements)

References 18 publications

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“…Bleeding with 61.4% were the predominant cause; it remains a common and major cause in African countries [13] [14]. Our figures are consistent with those of other authors namely Horo et al [17] in Ivory Coast in 2004, Gandzien et al [18] and Traore et al [19] …”

Section: Discussionsupporting

confidence: 90%

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Etiologies of Maternal Mortality in the Hospital Provincial Janson Sendwe in Lubumbashi (DR. Congo)

Odette¹,

Moise²,

Blood³

et al. 2017

OALib

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Objectives: The objective of this work was to analyze the etiologies of maternal deaths occurring in a tertiary hospital. Methodology: This is a descriptive cross-sectional study with retrospective data collection of maternal deaths that occurred in the reference provincial hospital Jason Sendwe from 2013 to 2015. All cases of maternal deaths in line with the definition of World Health Organization have been included. Data were analyzed by the software Epi info and Excel 2010 7.1.4.0. Results: Seventy seven (77) maternal deaths were identified during the study period. 74.03% of deaths occurred direct obstetric causes. Bleeding with 61.04% was the leading cause of maternal death followed by eclampsia (31.58%). Indirect causes were dominated by heart disease (30.0%). Note that 75.32% of deaths had occurred within 24 hours of admission. Conclusion: haemorrhage, eclampsia and infections are the main causes of maternal deaths in our study. The reduction of maternal deaths happens through access to emergency medication, transfusion and anesthetic and surgical teams in hospitals but also through the involvement of religious leaders, traditional and any community to better understand the population obstacles to reducing maternal mortality.

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Section: Discussionsupporting

confidence: 90%

“…Direct obstetric causes, as described elsewhere in other studies [13] [14] [15] [16], were in the majority. Bleeding with 61.4% were the predominant cause; it remains a common and major cause in African countries [13] [14].…”

Section: Discussionmentioning

confidence: 77%

Etiologies of Maternal Mortality in the Hospital Provincial Janson Sendwe in Lubumbashi (DR. Congo)

Odette¹,

Moise²,

Blood³

et al. 2017

OALib

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“…Hospital data offer limited insight into the scope of induced abortion in Senegal. Maternal death reviews in hospitals have found that hemorrhage is the leading cause of maternal death while abortion accounts for very little mortality (Dumont et al, 2006; Kodio et al, 2002). However, complications of induced abortion are often misclassified as hemorrhage or sepsis (Barreto et al, 1992; Khan, Wojdyla, Say, Gülmezoglu, & Van Look, 2006).…”

Section: Introductionmentioning

confidence: 99%

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal

Suh

2014

Social Science & Medicine

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Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal’s national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in nearly 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications.

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“…In a community-based study in Senegal, estimates of maternal mortality ratio in three regions ranged from 436 to 852 per 100,000 live births. Two-thirds were due to direct obstetric causes, the commonest being haemorrhage [3]. In the United Kingdom, the risk of maternal death from haemorrhage is about 1 in 100 000 births [4].…”

Section: Introductionmentioning

confidence: 99%

Misoprostol for treating postpartum haemorrhage: a randomized controlled trial [ISRCTN72263357]

Hofmeyr¹,

Ferreira²,

Nikodem

et al. 2004

BMC Pregnancy Childbirth

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BackgroundPostpartum haemorrhage remains an important cause of maternal death despite treatment with conventional therapy. Uncontrolled studies and one randomised comparison with conventional oxytocics have reported dramatic effects with high-dose misoprostol, usually given rectally, for treatment of postpartum haemorrhage, but this has not been evaluated in a placebo-controlled trial.MethodsThe study was conducted at East London Hospital Complex, Tembisa and Chris Hani Baragwanath Hospitals, South Africa. Routine active management of the third stage of labour was practised. Women with more than usual postpartum bleeding thought to be related to inadequate uterine contraction were invited to participate, and to sign informed consent. All routine treatment was given from a special 'Postpartum Haemorrhage Trolley'. In addition, participants who consented were enrolled by drawing the next in a series of randomised treatment packs containing either misoprostol 5 × 200 μg or similar placebo, which were given 1 orally, 2 sublingually and 2 rectally.ResultsWith misoprostol there was a trend to reduced blood loss ≥500 ml in 1 hour after enrolment measured in a flat plastic 'fracture bedpan', the primary outcome (6/117 vs 11/120, relative risk 0.56; 95% confidence interval 0.21 to 1.46). There was no difference in mean blood loss or haemoglobin level on day 1 after birth < 6 g/dl or blood transfusion. Side-effects were increased, namely shivering (63/116 vs 30/118; 2.14, 1.50 to 3.04) and pyrexia > 38.5°C (11/114 vs 2/118; 5.69, 1.29 to 25). In the misoprostol group 3 women underwent hysterectomy of whom 1 died, and there were 2 further maternal deaths.ConclusionsBecause of a lower than expected incidence of the primary outcome in the placebo group, the study was underpowered. We could not confirm the dramatic effect of misoprostol reported in several unblinded studies, but the results do not exclude a clinically important effect. Larger studies are needed to assess substantive outcomes and risks before misoprostol enters routine use.

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Levels and causes of maternal mortality in Senegal

Cited by 35 publications

References 18 publications

Etiologies of Maternal Mortality in the Hospital Provincial Janson Sendwe in Lubumbashi (DR. Congo)

Etiologies of Maternal Mortality in the Hospital Provincial Janson Sendwe in Lubumbashi (DR. Congo)

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal

Misoprostol for treating postpartum haemorrhage: a randomized controlled trial [ISRCTN72263357]

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