Maternal mortality at a tertiary care teaching hospital of India: a retrospective study

Abstract

BACKGROUND: Maternal death has been recognized as an area of maternal care that requires urgent attention. Making efforts to decrease maternal mortality is a matter of great concern to the obstetricians. MMR is a very sensitive index that reflects quality of reproductive care provided to the pregnant woman. OBJECTIVES: To assess the causes of maternal death and trends over a period of 5 years from July 2007 to July 2012 at a tertiary care teaching hospital of Kerala, South India. DATA AND METHODOLOGY: A retrospective hospital based study of maternal deaths which occurred over a period of 5 years from July 2007 to July 2012. The data regarding demographic profile and reproductive parameters were collected from patient’s records. The results were analysed using percentage and proportion and Pearson’s chi square analysis. The results have been compared with the scenario that existed 10 years ago. RESULTS: Over the study period there were 80,490 deliveries, (80217 live births) and 87 maternal deaths giving an MMR of 109/1, 00,000 LB. PPH was the most common direct cause while heart disease in pregnancy was the most common indirect leading cause. Most women died within 48 hours of admission. The age group 19-29 years was most affected. CONCLUSIONS: Most maternal deaths are preventable. Obstetric hemorrhage, toxemia of pregnancy and sepsis are the classic triad of the most important causes of maternal deaths. The provision of skilled care and timely management of complications can lower MMR in our setup. It’s heartening to realize that our MMR was definitely touching MDG target, but Kerala overall has the distinction of having a MMR of 81 in 2007-2009 statistics as published by SRS, office of Registrar General, India. KEYWORDS: Maternal mortality, postpartum hemorrhage, toxemia of pregnancy, developing country.