Trends in Maternal Mortality at the Lagos University Teaching Hospital, Lagos, Nigeria.

Background: Recent reports suggest that the burden of maternal mortality remains heavy in Sub-Saharan Africa; and that the fifth millennium development goal might not be achieved. As the target date 2015 draws near, we carried out a review of maternal mortality in a Teaching Hospital unit to assess the current situation.Objectives: To determine the Maternal Mortality Ratio (MMR), the clinical causes of maternal deaths and the numerical and etiological trends in maternal mortality at the Lagos University Teaching Hospital (LUTH).Method: The records of births and maternal deaths at LUTH over a five year period were reviewed. The data collected was analyzed to determine the maternal mortality ratio, the socio-biological factors associated with maternal death and the clinical causes. Comparisons are made with findings from previous studies done in LUTH and elsewhere.Results: The maternal mortality ratio was 2096 per 100000 live births. The mortality ratio has more than doubled over a period of 3 decades. Unbooked patients accounted for 7.1% of deliveries but contributed 88.1% of the maternal deaths.Majority (59.0%) of the deaths occurred within 24 hours of admission. The main clinical causes of death included sepsis (17.9%), hypertensive diseases (17.9%), abortion (11.2%), HIV/ AIDS infection (11.2%)), haemorrhage (9.0%) and medical disorders (18.7%).Conclusion: The maternal mortality ratio remains high in our unit in line with some other reports from Nigeria but in contrast to the trends in other developed and developing countries. Unless urgent action is taken, the 5th millennium development goal may not be achieved.Key words: Maternal mortality, maternal death,sepsis,hypertensive diseases, HIV/AIDS, haemorrhage, abortio