Gynecology & Reproductive Health
Open AccessA National Survey on Maternal and Perinatal Mortality Surveillance and Response in Senegal in 2024: Challenges and Prospects
Authors: Thiam O, Ndoye M, Niang K.
Abstract
Objective: The objective of this study was to establish the epidemiological and clinical profile of maternal deaths from 2019 to 2020 in healthcare facilities in the 14 regions of Senegal between January 1, 2019, and December 31, 2020.
Methodology: The cross-sectional retrospective study included all cases of maternal deaths meeting the WHO definition, following a process of collecting maternal death notification forms at the medical region level. The parameters studied concerned the availability of forms, sociodemographic characteristics, and clinical data extracted from death notification forms. The data, entered using a digital platform developed for this purpose, were analyzed using R software.
Results: The age of death ranged from 13 to 46 years and from 14 to 48 years. The average age increased from 28.4 (±6.9) years to 28.9 (±7.2) years. Gestation differentiated more multigravidas (49.6%-57.2%) than oligogravias (27.6%-21.9%) and primigravidas (22.8%-20.9%). Parity differentiated multiparous women (30.1%–41.8%), multiparous women (20.7%–18.3%), primiparous women (15.0%–15.1%), and nulliparous women (34.1%–24.8%). Medical history was dominated by diabetes (27.3%–24.3%), hypertension (23.7%–18.9%), and malaria (1.1%–2.3%). The gynecological and obstetric history was mainly less than four antenatal care visits (75.5%–73.7%) and at least one abortion (26.4%–25.8%). Referrals increased from 48.9% to 59.0%; deliveries in a public health facility from 60.9% to 65.0%, duration of labor from 7.2 (±4.3) hours to 6.9 (±5.3) hours, vaginal delivery from 50.2% to 48.9%, and cesarean section from 49.8% to 51.1%. The period of death was postpartum (68.7%–77.3%) and pregnancy (19.4%–15.0%). The place of death was a health facility (90.5%, of which 73.4% were public health facilities). The area of death was predominantly urban (93.3%–92.4%). The causes of death were dominated by hemorrhage (32.1%–32.7%), hypertension and its complications (28.7%–22.7%), anemia (6%–13%), infections (5.3%–4.5%), abortion (0.8%–0.6%), dystocia (0.8%-1.8%), malaria (0.4%-0.0%), HIV infection (0.4%-0%), other causes (19.6%-13.0%), and unknown causes (6.0%-7.3%).
Conclusion: Maternal mortality is a major public health issue. Maternal mortality remains very high worldwide and varies from region to region. The typical profile of maternal deaths was women aged 25-35, multiparous with no history of abortion, who had attended fewer than four antenatal care visits and who died after referral to a public health facility, less than 48 hours after a cesarean section, as a result of hemorrhage, hypertension, or complications from giving birth to a live child.
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