Review of maternal death in a tertiary care centre western India: a 5 year study

Abstract

Objectives: To study epidemiological aspects of maternal mortality in our centre. To study causes of maternal death and its impact on health care sector. To calculate the maternal mortality rate in our set up and its comparison with national data. To study measures to reduce maternal mortality. Methodology: A retrospective study of all maternal deaths according to definition of maternal mortality between1st January 2015 to 31st December 2020. Result: Indirect obstetrics causes related to maternal deaths includes anemia 40% (28/70), hypertension 37.14% (26/70), hepatitis 17.14% (12/70) and cardio-respiratory disease 12.85% (9/70). Direct causes of maternal deaths include haemorrhage 27.14% (19/70), septicemia 22.85% (16/70), DIC 21.42% (15/70), eclampsia 20% (14/70), cardio-respiratory failure 10% (7/70), hepatic encephalopathy 8.57% (6/70) pulmonary embolism 4.28% (3/70) and other causes like intraventricular failure, brain infarct, raised intracranial tension 4.28% (3/70). Sepsis includes post abortal sepsis, surgical wound sepsis, puerperal sepsis and causes of haemorrhage was APH, PPH and ruptured uterus. Conclusion: A number of social and economic factors affect maternal mortality. Proper antenatal care received during antenatal period, early hospitalization during labour and early referral to tertiary care hospitals, availability to blood products and multispecialty facilities are necessary to reduce maternal deaths. The poor illiterate unbooked women from rural areas and late referral to tertiary care centers are more vulnerable to maternal morbidity and mortality.

Keywords

• maternal mortality and morbidity
• anemia
• septicemia
• hemorrhage
• hypertension