Grim Face of Maternal Mortality at Tertiary Care Hospital of Rural India: A 16 Years Study

Abstract

Background: World health assembly set the millennium development goals (MDG) -5, with the aim of reduction in maternal mortality below 100 per 100,000 live births by year 2015. A maternal death is a very sensitive index that reflects the quality of reproductive care provided to the women of the reproductive age. It has serious implications to the family, the society and the nation. The burden of maternal mortality is quite high in India at 254 deaths per 100,000 live births as per the data of Sample Registration System (SRS) for the period 2004-06. However, India is committed to meet the MDG-5 target of less than 100 deaths per 100,000 live births by the year 2015. Objectives: To assess the proportion, causes and time trends of maternal deaths in a tertiary care hospital of rural India. Method: A retrospective hospital based study of 119 maternal deaths over a period of 16 years from January 1994 to December 2009. Results: Over the study period, there were 20,801 deliveries, giving a proportion of maternal deaths of 572/1,00,000 live births. Postpartum hemorrhage was the leading direct cause while infective hepatitis was indirect cause of maternal mortality. Most women died within 24 hours of admission to hospital. There was significant reduction in total number of deaths due to eclampsia and sepsis in last ten years. Conclusions: The proportion of maternal deaths in rural area is much higher than the national figure of 254 maternal deaths per 100,000 live births, yet most deaths in study area could have been avoided by minimizing the three delays i.e. delay in decision to seek care; delay in reaching care and delay in receiving care and by promoting overall safe motherhood.