High Maternal Mortality and Stillbirth In Wad Medani Teaching Hospital, Central Sudan

Maternal mortality and stillbirth are important indicators for obstetric care and health status. The reduction of maternal deaths and stillbirths are high priority for the international community. Effective services to improve overall maternal and perinatal health need targeted health and social policies and valid current epidemiological data. Thus, investigating the magnitude and distribution of the causes of maternal deaths and stillbirths are crucial to inform reproductive health policy-maker. The aim of this study was to investigate the incidence and causes of maternal deaths and stillbirths in Sudan. All maternal deaths and stillbirths during the period 2003- 2008 were reviewed and classified retrospectively.Stillbirth rate was calculated as the number of stillbirths per 1000 total births in the same time period.

There were 146 maternal deaths and 33034 live births, giving a maternal mortality ratio of 442/100,000 live births. Their age range 18-42 years with the mean (SD) of 30.57 (5.26) years. The mean (SD) of the parity was 3.49 (2.9). The most common cause of deaths was septicemia following obstructed labor or abortion-related sepsis, followed by hemorrhage, pre-eclampsia/ecalampsia, viral hepatitis and malaria. Anemia, heart disease, anesthesia, and ectopic pregnancy accounted for other causes of deaths.

Forty – two (28.7%), 12 (8.3%) and 92 (63.0%) of these 146 women had died during pregnancy, delivery and postpartum respectively.

Stillbirth rate was 29 per 1000 births; most of these (8 per 1000) were macerated stillbirth.Thus, in high-resource countries, intrapartum stillbirths comprise less than 10% of all stillbirths, while in low-resource countries higher proportions of stillbirths are thought to occur in the intrapartum period..

Thus at the current rate it is unlikely that the Millennium Development Goal related improving maternal and perinatal health will be achieved in this region by the year 2015.