Autopsy study of maternal death in a tertiary care centre

Abstract

Aims:The main objective is to study the gross pathology and microscopy of all organs in cases of maternal death, establish clinico-pathological correlation, to ascertain the exact cause of death and classify them into direct or indirect causes. Settings and Design: Cross sectional study of all medical autopsies Materials and Methods: A cross sectional study of all medical autopsies performed on deaths related to pregnancy at our tertiary care hospital over a period of four years. A total of 100 cases were studied. Maternal mortality autopsies where medico legal implications were involved or unnatural deaths not related to pregnancy were excluded from the study. Statistical Analysis used: Nil Results: The maximum no. of maternal deaths occurred in the age group 20-24 years (45%) followed by 30-34 years (19%). 62% of patients in our study were multigravidae. Majority of maternal deaths were seen in the postpartum period (75%). In the antepartum period maximum number of maternal deaths occurred in 3 rd trimester (14%) Our study revealed majority of maternal deaths were due to indirect causes (76%), Pregnancy induced hypertension was the most common direct cause of death (9%). The majority of cases were due to infectious aetiology (45%), while the other indirect causes were sepsis (14%), coagulopathy (8%) and hemodynamic (8%). Conclusion:The higher MMR in our study could be attributed to the fact that ours being a tertiary and referral care hospital, where patients are referred late and most of them are complicated cases and in serious condition at the time of admission. The low socioeconomic status of the patients, delay in referral and non-utilisation of the available antenatal care could be the major contributing factors. Our study revealed majority of maternal deaths were due to indirect causes especially respiratory infections and hepatitis Increased incidence of indirect causes reflect the present health care system. So adequate prenatal testing for these causes (infections), improving the nutritional status, sanitation can help in lowering the maternal mortality rate.