Anaesthesia-related maternal mortality: Ten-year impact of senior registrar anaesthesiologist-led practice in a Nigerian Tertiary Hospital

Abstract

Objective: To analyze the observed ten-year impact of Senior Registrar Anaesthesiologist-led obstetric anaesthesia practice on  anaesthesia-related maternal mortality at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

Design: Retrospective 10-year survey.

Setting: University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.

Subjects: 21,074 subjects, comprising pregnant women who had vaginal or Caesarean delivery, labour analgesic or obstetric anaesthetic  intervention by Anaesthesiologist, and all maternal deaths, in UPTH, from 2010 to 2019.

Results: Within the 10-year period under review 8,198 (38.90%) Caesarean and 12,876 (61.10%) vaginal births, totaling 21,074 deliveries  were conducted, with a Caesarean to vaginal delivery ratio of 1:1.57. Of the vaginal deliveries, 450 (2.14%) received labour analgesia,  mostly with single-shot spinal technique administered to 174 (0.83%). Subarachnoid block ranked as the most frequent anaesthetic modality used for Caesarean section with a value of 7,869 (37.34%), followed by general anaesthesia, 226 (1.07%). There were 392  maternal deaths of which pregnancy induced hypertension/preeclampsia-eclampsia, sepsis, and postpartum haemorrhage were the first,  second and third leading causes, recording corresponding values of 111 (28.316%), 86 (21.939%) and 71 (18.112%); high subarachnoid block (SAB) contributed 1 (0.2551 %) maternal death.

Conclusion: Anaesthesia-related death was the least contributor, with  hypertensive disease being the ranking cause of maternal mortality within the 10-year period of survey.