Measuring maternal mortality using a Reproductive Age Mortality Study (RAMOS)

BMC Pregnancy and Childbirth

Research Article

Adetoro Adegoke¹  Nynke van den Broek¹  Regine Unkels¹  Florence Mgawadere¹ 

[1] Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK;

关键词: Maternal mortality ratio;    RAMOS;    Cause of death;    Quality of care;   

DOI  :  10.1186/s12884-016-1084-8

 received in 2015-10-05, accepted in 2016-09-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAssessing the feasibility of conducting a prospective Reproductive Age Mortality Survey (RAMOS) study in the low-income setting of Mangochi District, Malawi to obtain cotemporaneous estimates of the number, cause of and conditions associated with maternal deaths (MD) in all women of reproductive age (WRA) (n = 207 688).MethodsMD among all deaths of WRA were identified using the ICD-10 definition. Cause of death and contributing conditions identified by a panel of experts using the classification system for deaths during pregnancy, childbirth and puerperium (ICD-MM).ResultsOut of 424 deaths of WRA, 151 were MD giving a Maternal Mortality Ratio (MMR) of 363 per 100,000 live births (95 % CI: 307–425). Only 86 MD had been reported via existing reporting mechanisms representing an underreporting of 43 %. The majority of MD (62.3 %) occurred in a health facility and were the result of direct obstetric causes (74.8 %) with obstetric haemorrhage as the leading cause (35.8 %), followed by pregnancy-related infections (19.4 %), hypertensive disorders (16.8 %) and pregnancy with abortive outcome (13.2 %). Malaria was the most frequently identified indirect cause (9.9 %). Contributing conditions were more frequently identified when both verbal autopsy and facility-based death review had taken place and included obstructed labour (28.5 %), anaemia (12.6 %) and positive HIV status (4.0 %).ConclusionThe high number of MD that occur at health facility level, cause of death and contributing conditions reflect deficiencies in the quality of care at health facility level. A RAMOS is feasible in low- and middle-income settings and provides contemporaneous estimates of MMR.

【 授权许可】

CC BY   
© The Author(s). 2016