Human immunodeficiency virus and AIDS and other important predictors of maternal mortality in Mulago Hospital Complex Kampala Uganda

BMC Public Health

Research Article

Betty Khainza¹  Pat Doyle²  Noreen Maconichie²  Paul Kiondo³  Julius N Wandabwa⁴  Emmanuel Othieno⁵  Benjamin Longo-Mbenza⁶ 

[1] Department of Anaesthesia, Makerere Medical School, P.O.Box 7072, Kampala, Uganda;Department of Epidemiology and population health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, UK;Department of Obstetrics and Gynaecology, Makerere Medical School, P.O.Box 7072, Kampala, Uganda;Department of Obstetrics and Gynaecology, Walter Sisulu University, Private Bag X1, 5117, Mathatha, South Africa;Department of Pathology, Makerere Medical School, P.O.Box 7072, Kampala, Uganda;Walter Sisulu University, Private Bag X1, 5117, Mthatha, South Africa;

关键词: Antenatal Care;    Maternal Mortality;    Maternal Death;    Birth Interval;    Severe Maternal Morbidity;   

DOI  :  10.1186/1471-2458-11-565

 received in 2010-08-09, accepted in 2011-07-14,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundWomen with severe maternal morbidity are at high risk of dying. Quality and prompt management and sometimes luck have been suggested to reduce on the risk of dying. The objective of the study was to identify the direct and indirect causes of severe maternal morbidity, predictors of progression from severe maternal morbidity to maternal mortality in Mulago hospital, Kampala, Uganda.MethodsThis was a longitudinal follow up study at the Mulago hospital's Department of Obstetrics and Gynaecology. Participants were 499 with severe maternal morbidity admitted in Mulago hospital between 15th November 2001 and 30th November 2002 were identified, recruited and followed up until discharge or death. Potential prognostic factors were HIV status and CD4 cell counts, socio demographic characteristics, medical and gynaecological history, past and present obstetric history and intra- partum and postnatal care.ResultsSevere pre eclampsia/eclampsia, obstructed labour and ruptured uterus, severe post partum haemorrhage, severe abruptio and placenta praevia, puerperal sepsis, post abortal sepsis and severe anaemia were the causes for the hospitalization of 499 mothers. The mortality incidence rate was 8% (n = 39), maternal mortality ratio of 7815/100,000 live births and the ratio of severe maternal morbidity to mortality was 12.8:1.The independent predictors of maternal mortality were HIV/AIDS (OR 5.1 95% CI 2-12.8), non attendance of antenatal care (OR 4.0, 95% CI 1.3-9.2), non use of oxytocics (OR 4.0, 95% CI 1.7-9.7), lack of essential drugs (OR 3.6, 95% CI 1.1-11.3) and non availability of blood for transfusion (OR 53.7, 95% CI (15.7-183.9) and delivery of amale baby (OR 4.0, 95% CI 1.6-10.1).ConclusionThe predictors of progression from severe maternal morbidity to mortalitywere: residing far from hospital, low socio economic status, non attendance of antenatal care, poor intrapartum care, and HIV/AIDS.There is need to improve on the referral system, economic empowerment of women and to offer comprehensive emergency obstetric care so as to reduce the maternal morbidity and mortality in our community.

【 授权许可】

CC BY   
© Wandabwa et al; licensee BioMed Central Ltd. 2011