Study of maternal mortality in a tertiary care hospital in a district of Maharashtra

Abstract

Background: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor, or thereafter. The major causes of maternal mortality are mostly preventable through regular antenatal checkup, proper diagnosis, and management of labor complications. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. Objective: To assess the maternal mortality ratio (MMR) and the causes of maternal mortality over a period of 3 years in a tertiary care hospital in Maharashtra. Materials and Methods: A hospital record-based study of maternal deaths over a period of 3 years from January 2012 to December 2014. The information regarding demographic profile and reproductive parameters were collected and results were analyzed using percentage and proportion with the help of Microsoft Excel 2007. Result: Average of MMR over 3 years study period (January 2012 to December 2014) was observed to be 410/1,00,000 live births. Most of the maternal deaths occurred in age group of 19-24 years (43.4%). Majority of maternal deaths was observed in multipara (52.2%) and women coming from rural area (52.9%). 44.9% of maternal deaths occurred within 24 h of admission. Hemorrhage was the leading direct cause of maternal deaths (33.8%) followed by eclampsia (10.3%) and sepsis (8.1%). Among indirect causes of maternal deaths anemia (14.7%) was the leading cause. Conclusion: MMR in our study was very high as compared to national average of 167/1,00,000 live births, being a tertiary care hospital as most of the patients were referred from peripheral centers. Most maternal deaths are preventable by intensive health education, basic obstetric care for all, strengthening referral and communication system and emphasizing on overall safe motherhood.