Clinico-pathological discrepancies in the diagnosis of causes of maternal death in sub-Saharan Africa: Retrospective analysis
2009

Diagnosing Causes of Maternal Death in Sub-Saharan Africa

Sample size: 139 publication Evidence: high

Author Information

Author(s): Jaume Ordi, Ismail Mamudo R, Carrilho Carla, Romagosa Cleofé, Osman Nafissa, Machungo Fernanda, Bombí Josep A, Balasch Juan, Alonso Pedro L, Menéndez Clara

Primary Institution: Maputo Central Hospital, Mozambique

Hypothesis

Clinical diagnostic errors may significantly impact maternal mortality rates in developing countries.

Conclusion

Clinico-pathological discrepancies may significantly affect maternal mortality in sub-Saharan Africa, indicating a need for improved diagnostic practices.

Supporting Evidence

  • 40.3% of maternal deaths had major diagnostic discrepancies.
  • High rates of false negative diagnoses were observed for infectious diseases.
  • Eclampsia was frequently misdiagnosed, leading to false positive diagnoses.

Takeaway

Doctors sometimes guess wrong about why mothers die after giving birth, and this study shows that checking with autopsies can help find the real reasons.

Methodology

A retrospective analysis of maternal autopsies was conducted to compare clinical diagnoses with autopsy findings.

Potential Biases

Potential bias due to the study being conducted in a tertiary referral hospital, which may have more complex cases.

Limitations

The study was conducted in a single large hospital, which may limit the generalizability of the findings to other settings.

Participant Demographics

Women who died during pregnancy or within 42 days after delivery at the Maputo Central Hospital.

Statistical Information

Confidence Interval

95% CI: 0.5%–49.5%

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000036

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