Clara Menendez | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 21, 2015

Background: The Millennium Development Goals for reducing maternal and neonatal mortality won’t be met because of the slow improvement in reducing their burden in Africa. Establishing the causes of these deaths is fundamental to design effective health programs. This is hampered by the inadequacy of vital registration systems in most African countries, the limitations of verbal autopsies and clinical records and the majority of these deaths occurring outside the health system. Although obstetric causes remain a significant cause of maternal mortality it is crucial to also tackle non-obstetric causes, mainly infectious. Infectious diseases might have a greater contribution to maternal and neonatal mortality than anticipated; more reliable information is needed to guide health programs. To reliably determine cause of maternal and neonatal deaths (CoD), complete diagnostic autopsy (CDA) -the gold standard for CoD determination-, is required. However, performing CDAs in developing settings has several limitations due to the lack of resources and trained personnel.

Methodology: A CDA was carried out in 139 maternal death cases. A subsequent validation study of minimally invasive autopsies (MIAs),-based on targeted small diagnostic biopsies of key organs-, is being carried out in women of reproductive age, and maternal and peri-natal deaths in a third level referral hospital in southern Mozambique.

Results: The results from the CDA showed that infectious diseases were very frequent as a CoD and that clinical errors were very common. MIAs have been performed in 97 women of reproductive age, 56 maternal deaths and 60 stillbirths and neonatal deaths.

Conclusion: Infectious diseases have a significant role and their prevention might have an important impact in reducing maternal deaths. The use of MIAs by being performed in rural settings might provide unique information for maternal and neonatal health prioritization.