Browsing by Author "Nassoro, Mzee M."

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    Maternal deaths due to obstetric haemorrhage in Dodoma Regional Referral Hospital, Tanzania
    (Hindawi, 2020) Nassoro, Mzee M.; Chiwanga, Enid; Lilungulu, Athanase; Bintabara, Deogratius
    Background. Despite the availability of comprehensive emergency obstetric care at Dodoma Regional Referral Hospital, deaths due to obstetric haemorrhage are still high. +is study was carried out to analyse the circumstances that had caused these deaths. Methods. A retrospective review of all files of women who had died of obstetric haemorrhage from January 2018 to December 2019was made. Results. A total of 18,296 women gave birth at DRRH; out of these, 61 died of pregnancy-related complications of the deceased while 23 (38%) died of haemorrhage, with many of them 10 (44%) between the age of 30 and 34. Many were grandmultiparous women 8 (35%) and almost half of them (11 (48%)) had stayed at DRRH for less than 24 hours. More than half (12(52%)) had delivered by caesarean section followed by laparotomy due to ruptured uterus (8 (35%)). +e leading contributing factors to the deaths of these women were late referral (6 (26%)), delays in managing postpartum haemorrhage due to uterineatony (4 (17%)), inadequate preparations in patients with the possibility of developing PPH (4 (17%)), and delay in performing caesarean section (3 (13%)).Conclusion. Maternal mortality due to obstetric haemorrhage is high at Dodoma Regional Referral Hospital where more than one-third of women died between 2018 and 2019. Almost all of these deaths were avoidable. +e leading contributing factors were late referral from other health facilities, inadequate skills in managing PPH due to uterine atony, delays in performing caesarean section at DRRH, and inadequate preparation for managing PPH in patients with abruptio placentae and IUFD which are risk factors for the condition. +ere is a need of conducting supportive supervision, mentorship, and other modes of teaching programmes on the management of obstetric haemorrhage to health care workers of referring facilities as well as those at DRRH. Monitoring of labour by using partograph and identifying pregnant women at risk should also be emphasized in order to avoid uterine rupture.
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    Maternal mortality in Dodoma regional referral hospital, Tanzania
    (Hindawi Limited, 2020) Nassoro, Mzee M.; Chetto, Paul; Chiwanga, Enid; Lilungulu, Athanase; Bintabara, Deogratius; Wambura, Jacquiline
    Maternal mortality has remained a challenge in Tanzania. The Tanzania Demographic and Health Survey 2015-16 has shown that the problem has been increasing despite various strategies instituted to curb it. It has been shown that most of the maternal deaths occurring in health facilities, whether direct or indirect, have other contributing factors. The objective of this study was to analyse causes and associated factors for maternal deaths in Dodoma Regional Referral Hospital (DRRH). A retrospective review of all files of the women who died in 2018 and were classified as maternal deaths. A total of 8722 women gave birth in DRRH, out of which 35 died and were confirmed as maternal deaths. The number of live births was 8404 making the maternal mortality ratio of 417 per 100,000 live births. The leading causes of maternal death were eclampsia (9), sepsis (6), ruptured uterus (5), and haemorrhage (5). The third-phase delay was the leading contributing factor to 19 maternal deaths. This includes delays in referral from another facility as well as delays in getting treatment at DRRH and inadequate skills of providers at both the referring facilities and DRRH. The first-phase and second-phase delays contributed to 7 and 6 deaths, respectively. Furthermore, poor antenatal care contributed to 2 deaths. Maternal mortality is still high in Dodoma Regional Referral Hospital. Eclampsia was the leading cause of maternal deaths in 2018 followed by sepsis and obstetric haemorrhage. Delays associated with health system factors (third-phase delay) contributed much more to maternal mortality than the first-phase delay. Mentorship programmes on management of obstetric complications need to be instituted in order to reduce maternal deaths in Dodoma Regional Referral Hospital.