Contrary to the thinking of many people, a nine-year review to determine the pattern of deaths in women at Wesley Guild Hospital, Ilesa, Osun State has named accidents as the most common cause of death in the hospital rather than pregnancy and pregnancy-related causes.

In a new study that looked at the reasons women die in the hospital, the researchers found that deaths due to accidents accounted for about half of all cases (57.2 per cent), followed by obstetric deaths (15.8 per cent). Deaths due to infections and cardiovascular diseases accounted for 13 per cent and 5.6 per cent, respectively.

The study, which indicated that injuries sustained from automobile accidents were responsible for 88.6 per cent of all trauma deaths, named causes of death from automobile accidents to include multiple injuries, head injury, and low blood volume or hypovolemia. Cases of assault (other than gunshot) and falls accounted for 5.7 per cent and 0.8 per cent, respectively.

In addition, deaths in women due to pregnancy and pregnancy-related causes were predominantly due to severe infection or uterine sepsis (51.5 per cent) and hemorrhagic shock (39.4 per cent). About 39 per cent of deaths from infection were due to septicemia. Acute bacterial meningitis, pneumonia, and malaria caused 23.1 per cent, 15.4 per cent, and 7.7 per cent of deaths from infections, respectively. Four cases of sudden unnatural deaths (other than trauma) were recorded.

Analysis of the cases of uterine sepsis showed that 66.7 per cent were due to induced abortion and 13.3 per cent to still birth. But 50 per cent of deaths from bleeding (obstetric hemorrhage) were due to complications of induced abortion.

Ironically, they indicated that all the cases of induced abortion were unbooked cases referred from private health facilities.

The study, which was published in International Journal of Women’s Health, involved 215 cases of female death whose ages ranged from zero to 75 years. It involved Olutoyin Omoniyi-Esan, Olaejirinde Olaofe, Mary Onwubuya, Oluseyi Fadahunsi and Akinwumi Komolafe, all from the Departments of Morbid Anatomy and Forensic Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife.

In total, the female deaths were autopsied during the study period, accounting for 30.6 per cent of all autopsies done during the study period. The causes of death were classified into trauma, obstetrics/gynecology, infection, cardiovascular, neonatal, sudden unexpected death (other than trauma), and cancer, gastrointestinal, renal, and unknown causes.

The researchers, who remarked that autopsies on women who died from cancer were few, stated the need for clinicians to ascertain the actual cause of death in women who die from cancer.

Although the study which was carried out in Wesley Guild Hospital Ilesa, Obafemi Awolowo University Teaching Hospital Complex, a tertiary health centre that caters for the health needs of the people of Ijesha and its environs is not reflective of the exact situation in the population, the researchers emphasised the need for preventive efforts geared towards reduction of deaths in women to include reduction of trauma as well as obstetric deaths.

They wrote: “Much emphasis had been placed on reduction of maternal mortality; policy makers should now consider how to further reduce automobile fatalities among women and also the general populace.”
They added that a more concerted effort was needed in the implementation of already existing policies on reduction of deaths in women.

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