Objective: To identify causes of maternal death and dysfunctions in patient management. Methodology: Retrospective and descriptive study, in the department of gynecology and obstetrics, which covered a period of 4 years (2014 to 2017). Results: In our study, the intra-hospital maternal mortality ratio was 665 per 100,000 live births. The average age of the deceased patients was 25 years. The majority were in the informal sector (46.7%) and without a profession (41.3%). The patients had an average parity of 2.5. At least 4 ANCs were performed in 47.6% of our patients who had been evacuated in 89.3% of the cases. Direct obstetrical causes were the most common (78% of cases vs. 22% for indirect causes). Hemorrhage accounted for 67.4% of direct obstetrical causes (and were dominated by haemorrhages in the immediate postpartum (50.8%)), followed by vasculo-renal syndromes (26.4%) and infections (6.2%). The deaths were mainly due to "3 delays" with, 89.3% of delay at the initial consultation. The dysfunctions found at the Teaching Hospital of Cocody were the lack of blood products and the unavailability of operating theaters which were permanently occupied. Maternal deaths were preventable in 91.3% of the patients in our study. Conclusion: In sub-Saharan Africa, dysfunctions in health services are most often responsible for most maternal deaths.
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