Dying undelivered

Abstract

This paper aims to stimulate discussion and awareness of this double tragedy of obstetric practice in the tropics. This was an 8-year retrospective review of all the patients who died undelivered in a tertiary health care institution serving a population of over a million people. The incidence of dying undelivered was 141/100 000 deliveries and this was highest in the extremes of age and parity. Patients who died undelivered contributed 28·30% of all the maternal deaths in the hospital during the period of study. The maternal mortality rate in the unbooked patients who died undelivered was three times that for the booked. Severe hypertension and ruptured uterus were the greatest association in patients who died undelivered. More than 46% of the fetuses were alive for more than 6 hours from the time of admission to the time of demise of their mothers. Most of the deaths, both maternal and perinatal, were avoidable. Dying undelivered is a significant aspect of maternal deaths in the tropics. The right of the helpless, unborn fetus of a moribond mother should be protected as much as possible. More reports are needed urgently to create awareness about the place of post mortem caesarean section.