Pregnancy Related Causes of Deaths in Ghana: A 5-Year Retrospective Study

Abstract

Objective: Data on maternal mortality varies by region and data source. Accurate local-level data are essential to appreciate its burden. This study uses autopsy results to assess maternal mortality causes in southern Ghana. Method: Autopsy log books of the Department of Pa-thology, Korle-Bu Teaching Hospital Mortuary were reviewed from 2004 through 2008 for pregnancy relat-ed deaths. Data were entered into a database and ana-lyzed using SPSS statistical software (Version 19). Results: Of 5,247 deaths among women aged 15-49, 12.1% (634) were pregnancy-related. Eighty one per-cent of pregnancy-related deaths (517) occurred in the community or within 24 hours of admission to a health facility and 18.5% (117) occurred in a health facility. Out of 634 pregnancy-related deaths, 79.5% (504) re-sulted from direct obstetric causes, including: haemor-rhage (21.8%), abortion (20.8%), hypertensive disor-ders (19.4%), ectopic gestation (8.7%), uterine rupture (4.3%) and genital tract sepsis (2.5%). The remaining 20.5% (130) resulted from indirect obstetric causes, including: infections outside the genital tract, (9.2%), anemia (2.8%), sickle cell disease (2.7%), pulmonary embolism (1.9%) and disseminated intravascular coag-ulation (1.3%). The top five causes of maternal death were: haemorrhage (21.8%), abortion (20.7%), hyper-tensive disorders (19.4%), infections (9.1%) and ectop-ic gestation (8.7%). Conclusion: Ghana continues to have persistently high levels of preventable causes of maternal deaths. Com-munity based studies, on maternal mortality are urgent-ly needed in Ghana, since our autopsy studies indicates that 81% of deaths recorded in this study occurred in the community or within 24 hours of admission to a health facility.