Bleeding, leading cause of death of pregnant women at LASUTH

A 10-year autopsy-based study of maternal mortality in Lagos State University Teaching Hospital, Lagos, Nigeria has identified bleeding as the leading cause of death in pregnant women.

In the study, researchers found 27.7 per cent of maternal deaths were due to bleeding while 17.7 per cent were due to cardiovascular related diseases such as heart failure and intracranial cardiovascular accident in pregnancy in the women. Other direct causes of death include eclampsia (17.4 per cent) and obstructed labour (14.9 per cent).

In all, the total cases of maternal autopsies done during the 10-year period were 328 out of 11,552 autopsies done for the period accounting for 2.84 per cent of all autopsy cases.

The study, which included all deaths seen at the hospital from January 01, 2005 to December 31, 2014, reported that 54.6 per cent of these deaths occurred in the age group 26 to 35 years and 73.2 per cent of death occurring in the active childbearing age of 21 to 35 years.

LASUTH is the main state-owned tertiary institution and the referral centre to the over 30 general hospitals in the state. The teaching hospital also serves as the referral centre to other hospitals in the contiguous states.

The 2017 study was published by the Nigerian Journal of Clinical Practise. It involved FA Faduyile; SS Soyemi; FE Emiogun; and JO Obafunwa, all from the Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.

They, however, declared that bleeding, cardiovascular disease and eclampsia, the three leading causes of death in the study are highly avoidable and treatable.

The researchers said that these deaths reflected the inadequacy of the emergency obstetric response in the country, adding that adequate prenatal testing for these indirect causes of death such as heart failure has the potential to lower maternal mortality to a significant extent.

According to the researchers, “We recommend that thorough cardiovascular evaluation and management is instituted into the antenatal clinic visits.

“The government should focus more on the emergency response of the health system with regards to availability of blood and blood products in our hospitals.”

Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

The average maternal mortality rate in Nigeria is estimated to be 704/100,000 live births, although this ranges from 165 to 1549 deaths per 100,000 live births in the South-Western and North-Eastern parts of the country, respectively.