{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:36:54Z","timestamp":1793417814284,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,10,10]],"date-time":"2011-10-10T00:00:00Z","timestamp":1318204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic>\u2002This study examines the leading causes of maternal mortality in Ghana, classifies the main causes of maternal deaths and suggests how maternal care can be improved.\u2002<jats:italic>Design.<\/jats:italic>\u2002Retrospective review.\u2002<jats:italic>Setting.<\/jats:italic>\u2002Komfo Anokye Teaching Hospital, Ghana.\u2002<jats:italic>Sample.<\/jats:italic>\u2002Three hundred and twenty\u2010two maternal deaths with 30 269 live births in the period 1 January 2008 to 30 June 2010.\u2002<jats:italic>Methods.<\/jats:italic>\u2002Data on maternal mortality and morbidity were retrieved from the Biostatistics Unit of the hospital.\u2002<jats:italic>Main Outcome Measures.<\/jats:italic>\u2002Maternal mortality ratio (MMR), case fatality rate, leading causes of maternal deaths, duration of admission and staff\/patient ratio.\u2002<jats:italic>Results.<\/jats:italic>\u2002The MMR was calculated to be 1 004 per 100 000 live births (95% confidence interval 895.0\u20131113.2). Of these, 71.1% were direct deaths, 22.4% were indirect deaths and 6.5% were unclassified. Hypertensive states of pregnancy were the leading cause of mortality (26.4%) and, together with hemorrhage, genital tract sepsis and early pregnancy deaths, accounted for 62.2% of all\u2010cause maternal deaths and 87.3% of direct deaths. Infection and sickle cell disease accounted for 13.7% of all\u2010cause maternal deaths and 61.1% of indirect deaths.\u2002<jats:italic>Conclusions.<\/jats:italic>\u2002Hypertensive states of pregnancy were the current leading cause of maternal mortality. Adopting a multi\u2010pronged approach through reducing delays in access to emergency obstetric care, promoting contraceptive use, encouraging early, regular antenatal attendance and shared antenatal care with the medical team is essential to tackle the situation.<\/jats:p>","DOI":"10.1111\/j.1600-0412.2011.01249.x","type":"journal-article","created":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T03:42:35Z","timestamp":1311824555000},"page":"87-92","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Maternal mortality in Ghana: a hospital\u2010based review"],"prefix":"10.1111","volume":"91","author":[{"given":"QIN YI","family":"LEE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALEXANDER T.","family":"ODOI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HENRY","family":"OPARE\u2010ADDO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EDWARD T.","family":"DASSAH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,10]]},"reference":[{"key":"e_1_2_7_2_2","unstructured":"WHO UNICEF UNFPA The World Bank.Maternal mortality in 2005: Estimates developed by WHO UNICEF UNFPA and the World Bank.2007. Available online at:http:\/\/www.who.int\/making_pregnancy_safer\/documents\/9789241596213\/en\/index.html(accessed August 31 2010)."},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_7_4_2","unstructured":"55\/2.United Nations Millennium Declaration.2000. Available online at:http:\/\/mdgs.un.org\/unsd\/mdg\/Resources\/Static\/Products\/GAResolutions\/55_2\/a_res55_2e.pdf(accessed August 9 2010)."},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60325-X"},{"key":"e_1_2_7_6_2","unstructured":"UN.Millennium Development Goals: 2010 progress chart. 23 June2010. Available online at:http:\/\/mdgs.un.org\/unsd\/mdg\/Resources\/Static\/Products\/Progress2010\/MDG_Report_2010_Progress_Chart_En.pdf(accessed August 9 2010)."},{"key":"e_1_2_7_7_2","volume-title":"International statistical classification of diseases and related health problems: tenth revision, volume 2. 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