Profile of Maternal and Foetal Complications during Labour and Delivery among Women Giving Birth in Hospitals in Matlab and Chandpur, Bangladesh|
Huda, Fauzia Akhter; Ahmed, Anisuddin; Dasgupta, Sushil Kanta; Jahan, Musharrat; Jannatul, Ferdous; Koblinsky, Marge; Ronsmans, Carine & Chowdhury, Mahbub Elahi
Worldwide, for an estimated 358,000 women, pregnancy and childbirth end in death and mourning, and
beyond these maternal deaths, 9-10% of pregnant women or about 14 million women per year suffer
from acute maternal complications. This paper documents the types and severity of maternal and foetal
complications among women who gave birth in hospitals in Matlab and Chandpur, Bangladesh, during
2007-2008. The Community Health Research Workers (CHRWs) of the icddr,b service area in Matlab
prospectively collected data for the study from 4,817 women on their places of delivery and pregnancy outcomes.
Of them, 3,010 (62.5%) gave birth in different hospitals in Matlab and/or Chandpur and beyond.
Review of hospital-records was attempted for 2,102 women who gave birth only in the Matlab Hospital
of icddr,b and in other public and private hospitals in the Matlab and Chandpur area. Among those,
1,927 (91.7%) records were found and reviewed by a physician. By reviewing the hospital-records, 7.3%
of the women (n=1,927) who gave birth in the local hospitals were diagnosed with a severe maternal
complication, and 16.1% with a less-severe maternal complication. Abortion cases - either spontaneous
or induced - were excluded from the analysis. Over 12% of all births were delivered by caesarean section
(CS). For a substantial proportion (12.5%) of CS, no clear medical indication was recorded in the hospitalregister.
Twelve maternal deaths occurred during the study period; most (83%) of them had been in contact
with a hospital before death. Recommendations include standardization of the hospital record-keeping
system, proper monitoring of indications of CS, and introduction of maternal death audit for further improvement
of the quality of care in public and private hospitals in rural Bangladesh.
Caesarean section; Delivery; Foetal complications; Hospitals; Maternal complications; Maternal mortality; Perinatal mortality; Record-keeping; Bangladesh