Severe Obstetric Morbidity of the Third Trimester, Delivery and Early Puerperium in Niamey (Niger)

Alain Prual, Dominique Huguet, Olivier Garbin, Gomna Rabe


Epidemiological data about maternal morbidity are rare. The present study, carried out in Niamey, capital of Niger, was designed to measure the incidence of maternal morbidity among women delivering in hospital. Severe complications occured in 232 of the 4,081 deliveries during the study period (6,450/100,000 live births). Maternal morbidity ratio was 11 times higher than the maternal mortality ratio. Incidence rates of the major morbidities (per 100,000 live births) were: obstructed labour 3,614, hypertensive disorders of pregnancy 1,159, haemorrhage 855, and puerperal sepsis 220. The incidence and case fatality rates of severe complications were both high, suggesting a lack of efficiency of maternal health services in spite of a high concentration of health personnel and a large accessibility to services in Niamey. (Afr I Reprod Healthl998;2(1):10—19)

KEY WORDS: Maternal morbidity, developing countries, obstetric complications


World Health Organization. Maternal Mortality Ratios and Rates; A Tabulation of Available Information. Third Edition. 100 p.Maternal Health and Safe Motherhood Programme, WHO., Geneva, 1991

World Health Organization & UNICEF. Revised 1990 estimates of maternal mortality. A new approach by WHO and UNICEF. WHO, Geneva, 1996

Rosenfield A, Maine D. Maternal Mortality-A Neglected Tragedy. Where is the M in MCH? Lancet 1985;2(8446):83—5

Howard D. Aspects of maternal morbidity: the experience of less developped countries. In: Jellife DB, Jellife EFP, eds. Advances in International Maternal and Child Health. Oxford: Clarendon Press, 1987;7:1—21.

Liskin LS. Maternal morbidity in developing countries: a review and comments Intl Gynecol Obstet 1992;37: 77—87

World Health Organization Technical Working Group. Measuring reproductive morbidity. Report of a Technical Working Group. Geneva, WHO, 1989

Huguet D, Prual A, Fassin D, Traore M. Maternal Mortality in a Sahelian Capital. Lancet 1989;1(8637):557

Huguet D, Prual A. La Sante Maternelle ii Niamey, Analyse de Ia Situation. 163 p. Ministère de la Sante Publique et des Affaires Sociales, Republique du Niger, Niamey, 1988.

Thuriaux MC, Lamotte JM. Maternal mortality in developing countries: a note on the choice of the denominator. mt J Epidemiol 1984;13(2): 246-7

Vangenderhuysen C, Banos JP, Taher M: Mortalité maternelle évitable en milieu urbain a Niamey (Niger). Cahiers Sante 1995;5:49—54

Centre National de la Sante Familiale, Ministère de la Sante Publique et des Affaires Sociales, Republique du Niger et Centre pour la Population et la Sante Familiäle, Columbia University, USA. Rapport de l’Enquete en Sante Familiale: Connaissances, Attitudes, Pratiques (C.A.P.). Niamey, 1987

World Health Organization Study Group. The hypertensive disorders of pregnancy. Technical Report Series 758, Geneva, 1987

Hassan TJ, Baqal R, Jafarey SN, Alam SE: Maternal morbidity in the Department of Obstetric and Gynaecology, Jinnah Postgraduate Medical Centre Karachi. J Pak Med Assoc 1991;41(9): 223-5

Datta KK, Sharma RS, Razack PMA, Ghosh TK, Arora RR. Morbidity patterns amongst rural pregnant women in Alwar, Rajasthan; a cohort study. Health Popul Perspect Issues 1980;3(4): 282-92

The Kasongo Project Team. Antenatal screening for fetopelvic dystocias. A cost-effectiveness approach to the choice of simple indicators for use by auxilliary personnel I Trop Med Hyg 1984;87: 173-83

Harrison, KA. Child-bearing, health and social priorities: a survey of 22,774 consecutive hospital births in Zaria, Northern Nigeria. BritJ Obstet Gynaecol 1985;92(Suppl.5):1—118

Ozumba BC, Uchegu H. Incidence and management of obstructed labour in Eastern Nigeria. Aust NZJ Obstet Gynaecol 1991;31(3):213—6

Buekens P: Outcome measures of obstetrical and perinatal care. Quality Assurance in Health Care 1990;2(3—4):253—62

Armon PJ. Maternal deaths in the Kilimanjaro region of Tanzania. Trans Roy Soc Trop Med Hyg 1979;73 (3):284—8,

Bansal YP. Pre-eclampsia/eclampsia: a profile from Pumwani Maternity Hospital, Nairobi, Kenya, East Afr MedJ 1985;62(10):691—9

Mekbeb T, Ketsela K: Pre-eclampsia!eclampsia at Yekatit 12 Hospital, Addis Abeba, Ethiopia (1987—1989) East Afr MedJ1991;68(11):893—9

World Health Organization. Geographic variation in the incidence of hypertension in pregnancy. Am I Obstet Gynecol 1988; 158(1 ):80—3

Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. Epidemiology of preeclampsia and eclampsia in the United States, 1976—1986. Am J ObstetGynecol i990;163(2): 460—5

Bullough CH, Msuku RS, Karonde L. Early suckling and postpartum haemorrhage: controlled trial in deliveries by traditional birth attendants. Lancet 1989;2(8667):862—3

Prendiville WI, Harding JE, Elbourne DR, Stirrat GM. The Bristol third stage trial: active versus physiological management of third stage labour. BritMedJ 1988;297(6659):1295—300

Saint-Georges L, Crandon AJ. Immediate postpartum complications. AustNZlObstet Gynecol 1990;30(l): 52—6

Mabie WC. Placenta previa. Gun Perinatol 1992; 19(2):425—35

Bouvier-Colle MH,Salanave B, Ancel PY, Varnoux N, Fernandez H, Papiernik E, Bréart G, and the regional teams for the survey. Obstetric patients treated in intensive care units and maternal mortality. Eur I Obste Gynec Rep rod Biol 1996;65: 121—5

Konar M, Sikdar K, Basak S, Lahiri D. Maternal mortality: ten year’s survey in Eden hospital. I Med Assoc 1980;75(3):45—5l

Li-By, Dong AM, Zhuo JR. Outcomes of pregnancy in Hong-Giao and Qi-Yi communes. Am J Pub Health 1982;72(9. Suppl.): 30-2

Plummer FA, Laga M, Brunham RC, Piot P, Ronald AR, Bhullar V, Mati JY. Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology and risk factors. J Infect Dis 1987;156(1):92—8

Tshibamgu K, Mboloko E, Kizonde K, Bolemba L, Biayi M, Engendju K, Sinamuli K. Particula md rismes de la gravido-puerperalite en Afrique Centrale.I.Operation césarienne dans trois environment différents au Zaire. I Gynecol ObstetBiolReprod 1991;20(l):69—73


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