Table 3

In-facility maternal deaths with and without caesarean section in Sierra Leone in 2016

With caesarean sectionWithout caesarean sectionP value
n=99n=438
Age
Median (IQR)27 (20–32)27 (21–32)0.76*
 <1514 (14%)71 (16%)
 15–2424 (24%)88 (20%)
 25–3444 (44%)190 (44%)
 ≥3517 (17%)86 (20%)
Unknown0 (0%)3 (0.7%)
Gravidity
Median (IQR)3 (1–5)3 (2–6)0.10*
 125 (26%)86 (24%)
 2–556 (58%)197 (54%)
 ≥616 (16%)81 (22%)
Unknown2 (2%)74 (17%)
Parity
Median (IQR)2 (0–4)3 (1–5)0.005*
 025 (26%)57 (19%)
 1–456 (58%)156 (53%)
 ≥515 (16%)80 (27%)
Unknown3 (3%)145 (33%)
Number of antenatal care visits
Median (IQR)3 (2–3)3 (1–3)0.55*
 06 (11%)30 (13%)
 14 (7%)31 (13%)
 2–336 (64%)121 (51%)
 ≥410 (18%)56 (24%)
Unknown43 (43%)200 (46%)
Referred from<0.001†
Other hospital2 (2%)6 (2%)
Peripheral health unit51 (56%)89 (33%)
Home39 (43%)173 (65%)
Unknown7 (7%)170 (39%)
Time from admission to death
Median (IQR) number of days1.0 (0.3–3.7)0.7 (0.2–2.3)0.02*
Unknown1 (1%)144 (33%)
Time from start of operation to death
Median (IQR), hours, n=959.5 (4.4–81.5)N/A
Unknown4 (4%)N/A
Intraoperative findings
Uterine rupture23 (22%)N/A
Placental abruption11 (10%)N/A
Cause of death
Haemorrhage64 (73%)184 (44%)<0.001§
Hypertensive disorders20 (23%)72 (17%)0.29§
Sepsis12 (14%)47 (11%)0.58§
Embolism1 (1%)00.32§
Other direct causes019 (5%)0.03§
Indirect causes11 (12%)93 (22%)0.04§
Abortion012 (3%)0.14§
Unknown11 (11%)24 (5%)
Fetal death
Number of stillbirths (proportion)44 (59%)95 (46%)0.06§
Unknown25 (25%)232 (53%)
  • *Mann-Whitney U test.

  • †χ2 test.

  • ‡Categories according to Say et al,2 several contributing causes of death were noted for some patients.

  • §Fisher’s exact test.

  • ¶Fetal death included cases of death of one of two twins, and undelivered fetuses, and molar pregnancies were excluded; percentages may add up to above 100% due to rounding or patients appearing in multiple categories.

  • N/A, not applicable.