Distribution spatiotemporelle et caractéristiques des décès maternels à l’Hôpital Provincial Général de Référence de Kinshasa, principal hôpital de référence de ville de Kinshasa en RD Congo de janvier 2018 à juin 2023

Abstract

Objective: The objective of this study was to describe the profile and spatiotemporal distribution of maternal death cases recorded at the Kinshasa Provincial General Reference Hospital (HPGRK), one of the main referral structures in Kinshasa, capital of the Democratic Republic of Congo (DRC).

Method: A cross-sectional descriptive study was conducted at the HPGRK over a 5-year period, from January 2018 to June 2023. Sociodemographic and clinical variables were collected from maternal death review sheets. The spatial distribution of maternal death cases at the municipal level was carried out using thematic death maps produced using QGIS version 3.8 software. Frequencies and percentages were calculated for all qualitative variables and the mean and standard deviation for quantitative variables. All statistical analyses were performed using R version 4.4.1 software. and Excel.

Results: During this study, the maternal mortality rate was 2744.2 deaths per 100,000 live births. The year 2019 was the deadliest year with 4941.6 deaths per 100,000 live births and most of the deceased patients (28.2%) resided in the NGALIEMA commune. The majority of these patients were transferred (87%) for genital hemorrhage (42.1%). Direct obstetric causes of maternal death were the most incriminated (62%). Among these direct causes, hemorrhage (22.6%), pregnancy-induced hypertension (19.2%), and abortion complications (14.7%) were the most common.

Conclusion: The maternal mortality rate remains very high at HPGRK, despite the presence of qualified personnel. The year 2019 was the deadliest year and the vast majority of women who died were transferred patients and mainly resided in the commune of Ngaliema. Hemorrhages, pregnancy-induced hypertension, and abortion complications were the main causes of these deaths. A more balanced geographical distribution of secondary or tertiary health structures (with qualified personnel) could help reduce the number of maternal deaths in Kinshasa.