Contribution of ruptured uterus to maternal mortality in rural South Eastern Nigeria

Abstract

Context: Maternal mortality statistics in Nigeria derive mainly from urban based hospital data. In rural areas of the country where available medical facilities and trained medical personnel are inadequate, the incidence, and major causes of maternal death may differ.

Aims and Objectives: To provide information on maternal death in an entirely rural setting in Southeast Nigeria, and determine contribution of uterine rupture to maternal mortality.

Methods: Analysis of records of maternal deaths and ruptured uterus over a 10-year period in a rural Nigerian community.

Main Outcome Measure: Maternal deaths resulting from ruptured uterus.

Results: The Maternal Mortality ratio was 2659 / 100 000 maternities - 789 / 100,000 for booked and 8235 / 100,000 for unbooked women. Ruptured uterus accounted for 31.9% of deaths. Haemorrhage, obstructed labour, sepsis and eclampsia accounted for 29.2, 13.9, 12.5 and 8.3% of the deaths respectively. A patient each died from complications of abortion and anaesthesia. Perinatal mortality rate was 963 / 1000 births.

Conclusion: Ruptured uterus and obstructed labour were responsible for over half of the maternal deaths. High MMR and PNMR reflect paucity of maternal and public health services in the rural areas.

Keywords: maternal mortality, ruptured uterus, rural setting, Southeast Nigeria

Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 184-188