MATERNAL MORTALITY AT MUHIMBILI NATIONAL HOSPITAL, TANZANIA, 1999 - 2005: LEVELS, CAUSES AND CHARACTERISTICS

Objectives:To determine the levels, direct causes and characteristics of maternal mortality at Muhimbili National Hospital in Tanzania.
Methods: We used hospital data recorded systematically and routinely from 1999 to 2005. The outcome of interest was a maternal death that occurred at the hospital before discharge. We used descriptive analyses characterizing the outcome variable by maternal and obstetric factors.
Results: We found a maternal mortality ratio of 512 per 100,000 live births (95%CI, 465/100,000 - 559/100,000 livebirths) during the study period. Yearly maternal mortality ratios have been rising gradually over time. The top three direct obstetric causes of maternal deaths include eclampsia, 108 (23.5%), postpartum hemorrhage, 107 (23.3%) and anaemia in pregnancy, 52 (11.3%).
Conclusions:Although the current hospital-based data suggest underestimation of maternal mortality ratio, the observed constant maternal mortality risk calls for further strengthening of emergency obstetric care to reduce direct obstetric causes of maternal deaths.