Maternal death investigation, Greenville District, Sinoe County, Liberia, January 2017
Vivian Doedeh1, Maame Amo-Addae1, Joseph Asamoah Frimpong1,&, Lily Sanvee Blebo1, Faith Kamara1
1Liberia Field Epidemiology Training Program, Monrovia, Liberia
Joseph Asamoah Frimpong, Liberia Field Epidemiology Training Program, Monrovia, Liberia
in 2015, the World Health Organization estimated 1072 maternal mortalities per 100,000 live births in Liberia. Approximately 830 women die of pregnancy or complications of pregnancy and child birth daily worldwide. Maternal death in Liberia is a priority event, requiring reporting and investigation within 48 hours. We investigated a maternal death of a woman which occurred on 26th January, 2017 at the FJ Grant Hospital in Greenville, to describe the event and establish the cause of death for appropriate public health action. Maternal services in Liberia are free.
Greenville, capital City of Sinoe County has a population of 24,800. The investigation started on January 27, 2017. We reviewed medical records of the deceased, conducted interviews with community leaders, friends, parents and medical staff. Public Health actions were taken based on findings.
the deceased was 41-year old, gravida 13 para 10 at 14 weeks. Two weeks prior to her death (January 11), she started experiencing mild bleeding per vaginam with lower abdominal pain. She received first aid at the Kilo Community Clinic and was referred to FJ Grant Hospital but her husband declined to honor the referral, choosing home treatment with herbs until January 25 when bleeding became profuse and she collapsed. Evacuation of uterus was done at the hospital to stop the bleeding. She was transfused with the only a pint of blood available, donated by the doctor on duty, after all family members had declined to donate blood. She died the following day, January 26.
the likely cause of death was hemorrhagic shock from incomplete abortion. Contributing factors were: delay in seeking health care, poor family support, and non-availability of a blood bank at the referral hospital. We educated the community members on family support for the pregnant woman and recommended to the County Health Team to set up a functional blood.
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