[Maternal mortality: epidemiology, risk factors and evitability. About ten cases].

OBJECTIVES

To determine maternal mortality rate during the last decade as revealing the quality of obstetrical follow-up and the necessary measures to be taken.

PATIENTS AND

METHODS

A retrospective study conducted in the department of gynaecology in the military hospital in Tunis between 1990 and 2001, permitted to count 10 cases of maternal death.

RESULTS

Maternal mortality rate was about 33.72/100,000 live births. Mean age of patients was 31.2 years. Primiparity, multiparity, poor socio-economic conditions, high-risk pregnancies and bad follow-up were responsible in 5, 1, 6 and 3 cases and represent the risk factors of mortality. All deaths occurred after delivery, with 60% before 24 h. Causes of death were haemorrhage in 40%, gravidic hypertension in 20%, anesthetic accidents in 10%, acute hepatic failure in 10%, and infection in 10%. Indirect causes are responsible for 20% of cases.

DISCUSSION AND

CONCLUSION

Deaths were judged evitable in 66.6% of cases, which confirms, although maternal mortality has diminished in the recent past, the necessity of pursuing study of risk factors together with study of remedies to them.