Maternal public health in Guyana has recorded significant improvement with a lower level of deaths recorded for the year compared to the two previous years.
The Department of Public Information (DPI) in a release yesterday disclosed a Georgetown Public Hospital Corporation (GPHC) announcement that the institution has recorded low levels of maternal deaths while saving the lives of 303 critically-ill women this year.
This information was disclosed by Head of the Obstetrics and Gynecology Department at the GPH, Dr Rafi Rozan during a press conference yesterday, where he stated that this year, the number of recorded maternal deaths is 10, as compared to 17 in 2021, and 16 in 2022.
“In 2023, we would have had 10 maternal deaths as compared from the two previous years. There would have been a decline, seven of which are direct deaths and two of which are indirect and one yet to be classified… Direct obstetric deaths are basically caused due to a complication of pregnancy or a complication in child birth, termination, or complication arising from its management… Whereas an indirect death is basically caused by the pregnancy interfering or worsening an existing condition,” he explained.
“We would have had 4,860 deliveries this year, of which 1,569 were caesarean section, and 3,291 were spontaneous vaginal delivery. With regards to stillbirth, do note that the World Health Organization defines stillbirth as a baby who dies after 28 weeks of pregnancy but before or during birth,” he added.
Dr Rozan informed that globally, there are an estimated 2 million stillbirths every year, one in every 16 seconds. However, in Guyana there have been 54 this year, recording 11 for every 1,000 births.
The Every New Born Action Plan (ENAP) is a global initiative advocating for every country to have less than 20 still births by 2030 and Guyana is within that goal.
“In 2023, there could have been 303 patients that could have died but they survived. These are considered near miss… where pregnant mothers experience a severe complication during pregnancy, childbirth or within 42 days after delivery, but survive,” Dr Rozan said of the patients that GPH saved.
Part of the success, he related, is the massive improvement in the department regarding how a patient’s case and care is managed. According to the doctor, caesarean sections are now being done in a timelier manner taking approximately 10-15 minutes to get an emergency C-section case from the labour room and into the operating theatre.
“With regard to these 10 maternal deaths in 2023, do note that 70 per cent of these deaths were referred to Georgetown Public Hospital. And of these referrals, six were deemed critical, and critical is being defined as the need for intensive care unit admission. So, six of the seven were very critical and one was deemed non- critical. The six that were critical, came to the hospital intubated from the other hospitals that were referring, and do note, that referrals are not just from public hospitals but from private institutions as well,” he pointed out.
Dr Rozan attributed the decline in the number of admissions and other improvements, to multiple strategies that were implemented in the department such as increased staffing at the outpatient clinic to facilitate the growing number of high-risk patients; increased fetal monitoring; from admission to discharge, a patient being seen by a specialist at all times; the addition of a specialist in urogynecology; and a new unit for maternal fetal medicine, to give special care to the severe maternal morbidity and life-threatening cases.
Additionally, he noted that there have been significant improvements in the treatment and care of patients in this department which makes up 35-40 per cent of the patient load at the hospital.
