Maternal deaths due to indirect causes: Report from a tertiary care center of a developing country.

Abstract

To assess the causes of indirect maternal deaths. The Department of Obstetrics & Gynecology, of a tertiary referral center in Karachi, Pakistan, from January 2018 to December 2020. Maternal deaths were categorized according to World Health Organization guidelines into direct and indirect deaths. The total maternal deaths during the study period were 96, with 26 (27%) due to indirect causes. The mean age in the indirect group was 27 (range: 20-35) years, with only eight (31%) registered (attending for three of more antenatal visits). The mean gestational age was 33 (range: 22-39) weeks. Cesarean section was the main mode of delivery, in 13 (50%). Perinatal mortality was 68%. Cardiac and hepatic diseases (each six deaths, 23%) were the main causes of indirect maternal deaths. The majority of women (20; 76%) died during the postpartum period. Delays in seeking medical help, referral, and appropriate treatment were observed in 10, 9, and 7 cases, respectively. Indirect maternal deaths are an important cause of maternal mortality.