Maternal mortality in the University of Port Harcourt Teaching Hospital, Port Harcourt in the last year before the new millennium.

BACKGROUND: Maternal death in developing countries is still high and the causes are multifactorial. The unbooked primigravidae with severe pre-eclampsia/eclampsia constitute a high risk group.
METHODS: The data from case notes of all maternal deaths which occurred at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt between 1st of January and 31st of December 1999 formed the basis of this study. Case notes of all deaths were stored in the office of the head of department of obstetrics and gynaecology as soon as they occurred. Information was extracted from the case files at the end of the year. The total number of deliveries was obtained from the registers kept in labour and isolation wards respectively.
RESULTS: There were 45 maternal deaths; 40 (88.9%) among the unbooked and 5 (11%) among the booked mothers constituting a maternal mortality ratio of 23, 121.4 and 339.7 per 100,000 deliveries respectively. The combined mortality ratio was 2735.6 per 100,000 deliveries. Fifteen (37.5%) unbooked primigravidae died of severe pre-eclampsia/eclampsia. A total of 1645 mothers delivered, 1472 (89.5%) were booked while 173 (10.5%) were unbooked with the hospital.
CONCLUSION: Severe pre-eclampsia/eclampsia, haemorrhage and sepsis were the major causes of death. The high maternal mortality was common among the unbooked primigravidae who usually present late with pre-eclampsia/eclampsia. More research into the causes and management of pre-eclampsia/eclampsia are needed to reduce the high maternal mortality associated with it. Lack of antenatal care is also a high risk factor for maternal mortality.