Maternal mortality in south Iran: a seven-year survey.

Abstract

To evaluate the effect of recent improvements in health care in Iran in reducing the number of maternal deaths results of the present study are compared with previous data. Autopsies were conducted for 96 maternal deaths which occured from January 1970-December 1976 at the Pahlani University teaching hospitals. Deaths were classified as direct obstetric indirect obstetric and unrelated to obstetric events. During the 7 years of the study there was an incidence of 248.7 deaths/100000 live births. Leading causes for 58 deaths due to direct obstetric causes were infection (25) hemorrhage (11) pulmonary embolism (8) toxemia (6) and choriocarcinoma. Deaths due to indirect obstetric causes declined substantially from the previous study; Causes were chronic glomerulonephritis generalized miliary tuberculosis hepatic failure viral hepatitis cardiac disease and peritonitis. 25 maternal deaths (26%) resulted from unrelated causes including communicable and infectious diseases. 4 deaths due to ingestion of toxic substances were classified as suicides. Other causes were acute myeloblastic leukemia ependymoma of the cerebellum and amyloidosis of the kidney. Pregnancy wastage occured in 68% of the 96 pregnancies (79%) with maternal mortality. Although results indicate a significant reduction in the maternal death rate the pattern of diseases leading to maternal mortality has remained unchanged. Recommendations for prevention include improvement in sanitation prevention of communicable diseases upgrading the health care system and expansion of the new midwifery program.