Mortalité maternelle au centre de santé Roi Baudouin de (Dakar – Sénégal) : à propos de 308 cas.

Objectives: - To determine the epidemiologic profile and private clinics of the cases of maternal mortality at the centre de sante Roi Baudouin; - To identify the etiologies of the cases of maternal death at the centre de sante Roi Baudouin; - To determine the assumption of responsibility of the cases of maternal death at the centre de sante Roi Baudouin. Material and methods : It was about a longitudinal descriptive retrospective study relating to 308 cases of maternal death from January 1998 to December 2005 at the centre de sante Roi Baudouin; de Guediawaye, in suburbs of Dakar. We had included in the study all the patients died during the time of the gravido-puerperality during the study period. The studied parameters related to the socio-epidemiologic data, the clinical data on the pregnancy and the childbirth, the quality of the assumption of responsibility, the causes of maternal death and the forecast neonatal. The data were analyzed with the software Epi information-version 6. Results : The ratio of maternal death was of 615.8 per 100.000 live births. The Middle Age of the deaths was 28.4 years with extremes of 14 and 52 years. The average gestity was of 4 with extremes of 1 and 25. As for the parity, it was of 3.9 with extremes of 1 and 22. The multipares were the section most concerned, followed first calf cows. A woman on four had made more than 3 antenatal consultations. The majority of our patients were evacuated (53.6%), but only 18.2% of the patients had profited from a medicalized transport. The reasons for evacuation were dominated by the vasculo-renal haemorrhages (49%) and syndromes (19%). The majority of the patients (n=234) had been confined, that is to say 76% of the cases; by natural way (45%) and Caesarean (32%). The patients had died of direct obstetrical causes in 80%, the indirect causes accounted for only 17,5%. The obstetrical causes death were dominated by the abrupto placentae, the haemorrhage of the postpartum and the uterine rupture. The maternal death was associated in more half of the cases of a fetal death (51.3%). The maternal age, the parity, the quality of the antenatal consultations, the hemorrhagic pathology coupled with the way of childbirth influenced occurred of maternal death. Conclusion: Maternal mortality remains a major concern at the centre de sante Roi Baudouin. The reduction of this mortality passes by operation correct 24 hours a day hours of the other ONEC centers of the area of Dakar, the availability of blood and its derivatives and the creation of a functional service of intensive care.