Maternal near-miss and death among women with postpartum haemorrhage: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey

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dc.contributor.authorSotunsa, J.O
dc.contributor.authorAdeniyi, A.A
dc.contributor.authorImaralu, J.O
dc.contributor.authorFawole, B
dc.contributor.authorADEGBOLA, O
dc.contributor.authorAimakhu, C.O
dc.contributor.authorAdeyemi, A.S
dc.contributor.authorHunyibo, K
dc.contributor.authorDada, O.A
dc.contributor.authorAdetoro, O.O
dc.contributor.authorOladapo, O.T
dc.date.accessioned2020-03-02T10:43:04Z
dc.date.available2020-03-02T10:43:04Z
dc.date.issued2019
dc.descriptionStaff publicationsen_US
dc.description.abstractObjective To investigate the burden and health service events surrounding severe maternal outcomes (SMO) related to life threatening postpartum haemorrhage (PPH) in Nigerian public tertiary hospitals. Design Secondary analysis of a nationwide cross-sectional study. Setting Forty-two tertiary hospitals. Population Women admitted for pregnancy, childbirth or puerperal complications. Methods All cases of SMO [maternal near miss (MNM) or maternal death (MD)] due to PPH were prospectively identified using WHO criteria over a 1-year period. Main outcome measures Incidence of SMO, health service events, case fatality rate (CFR) and mortality index (MI: % of death/ SMO). Results Postpartum haemorrhage occurred in 2087 (2.2%) of the 94 835 deliveries recorded during the study period. A total of 354 (0.3%) women had an SMO (103 MD; 251 MNM). It was the most frequent obstetric haemorrhagic complication across hospitals. PPH had the highest maternal mortality ratio (112/ 100 000 live births) and the recorded MI (29.1%) and CFR (4.9%) were second only to that of ruptured uterus. About 83% of women with SMO were admitted in a critical condition with over 50% being referred. MD was more likely when PPH led to neurological (80.8%), renal (73.5%) or respiratory (58.7%) organ dysfunction. Although the timing of life-saving interventions was not statistically different between the cases of MD and MNM, close to one-quarter of women who died received critical intervention at least 4 hours after diagnosis of life-threatening PPH. Conclusions Postpartum haemorrhage was a significant contributor to obstetric haemorrhage and SMO in Nigerian hospitals. Emergency obstetric services should be enhanced at the lower levels of healthcare delivery to reduce avoidable deaths from PPH.en_US
dc.identifier.citationSotunsa, J.O. Adeniyi, A.A. Imaralu, J.O. Fawole, B. Adegbola, O. Aimakhu, C.O. Adeyemi, A.S. Hunyibo, K. Dada, O.A. Adetoro, O.O. Oladapo, O.T. Maternal near-miss and death among women with postpartum haemorrhage: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey. British Journal of Obstetrics and Gynaecology 2019;126(S3):19-25.en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/7947
dc.language.isoenen_US
dc.publisherBritish Journal of Obstetrics and Gynaecologyen_US
dc.relation.ispartofseriesBritish Journal of Obstetrics and Gynaecology;Vol.126
dc.subjectMaternal deathen_US
dc.subjectObsteric haemorrageen_US
dc.subjectPostpartum Haemorrhageen_US
dc.subjectSevere acute maternal outcomeen_US
dc.subjectResearch Subject Categories::MEDICINE::Surgery::Obstetrics and women's diseases::Obstetrics and gynaecologyen_US
dc.titleMaternal near-miss and death among women with postpartum haemorrhage: a secondary analysis of the Nigeria Near-miss and Maternal Death Surveyen_US
dc.typeArticleen_US
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