Maternal death review is an important tool for categorizing causes of maternal mortality, as this data can then be used to guide interventions to reduce maternal deaths. Rwanda has achieved a 76% reduction in maternal mortality since 1990. We aimed to analyze the specific causes of maternal mortality in Rwanda over the last 6 years, as well as the demographic characteristics of those women who died in pregnancy, during delivery or in the postpartum period.METHODS:
The Rwandan maternal death audit database for the years 2009–2014 was analyzed. Causes of death were categorized according to the “WHO Application of ICD-10 to deaths during pregnancy, childbirth and the puerperium.” Maternal demographic data and causes of death were analyzed using descriptive statistics and chi-square tests.RESULTS:
There were 1,160 maternal deaths reported during 2009–2014. Obstetric hemorrhage was the most frequent cause of death (39%), followed by non-obstetric complications (19.3%), pregnancy-related infection (11.3%), and hypertensive disorders (10.2%). When stratified by age, however, non-obstetric complications were the most common cause of death for women younger than 20 (P<.001). Other causes of death (such as those with an abortive outcome and other obstetric complications) were the most common cause of death among primiparous women, while obstetric hemorrhage was the most common cause of death in multiparous women.CONCLUSION:
Obstetric hemorrhage remains an important contributor to maternal mortality in Rwanda. A more detailed examination of the causes of maternal mortality is needed in order to identify areas for intervention and improvement in outcomes.