Maternal Death Review to Know the Determinants of Maternal Mortality in a District Hospital of Central India

Abstract

Background: Avoiding maternal deaths is possible even in resource-limited countries, but r correct information on which to base maternal health programmes is required. Knowing the level of maternal mortality is not enough to prevent further deaths; there is need to understand the underlying factors that led to the deaths. Maternal death review is one of the oldest and the most documented methods that can be effective in improving emergency obstetric care and maternal outcomes. Objectives: To study the maternal deaths in a District level tertiary health care unit so as to find the determinants of maternal mortality and suggest local solutions. Methods: Maternal deaths occurring in a tertiary care district hospital were analysed using maternal death review form. Socio demographic profile, antenatal care, labour and delivery parameters and cause of death was studied. Analysis was done using computer software stata. Results: In the present study there were 12 maternal deaths among 4953 deliveries giving a Maternal Mortality ratio of 242.27 per 1,00,000 live births. Pulmonary embolism was the leading cause of death complicating obstetric disorders of pregnancy induced hypertension and eclampsia. Most of the women died in the postpartum period. The affected population was rural, illiterate and belonged to the 19-29 years age group. Conclusions: Maternal death review is an important tool for delineating the causes of maternal deaths and finding cause specific and need based local solutions for curtailing maternal mortality.

Make every mother and child count: a retrospective analysis of maternal mortality at medical college tertiary care hospital, Tamilnadu, India

“…Previous study in India and abroad have reported that the extramural maternal death range from 31.2 to 76.4% whereas in our study it is 65.6%. [8][9][10][11] More higher mortality ratios had been found in the various studies [12][13][14][15][16][17] The majority of deaths in our study were in the age group 20 to 29 -64.3% which is in accordance with the age distribution of maternal death in India -MMR Bulletin of India 2011 to 2013 -where it is 68% in the age group 20 to 29 years. 18 The majority of maternal deaths were from the lower socio economic strata 75.7% and 69.1% of these mothers were multi gravida with spacing less than 3 years especially the unbooked mothers who were nomadic and illiterate who not only have resource constraint but are also not self-empowered to take their own decisions or to understand the seriousness of their situation.…”

“…These are the major risk factors of maternal mortality. 8 In our study the direct causes of maternal deaths are 40% hypertensive disorders complicating pregnancies, 30% haemorrhage, Anemia with failure -17.2%, Heart disease complicating pregnancies -6.8%, Sepsis -3.4%, other causes 3.4%. As per WHO 2010 13% of maternal deaths were due to hypertensive disorders complicating pregnancies, but in our study of the direct causes of maternal deaths, hypertensive disorders complicating pregnancies tops the list -40%.…”

A study of maternal mortality in a tertiary care hospital

“…In a study by Tayade et al reported an MMR of 242 at Wadgwa, Maharashtra where as Shivkumar et al reported MMR of 974 at VIMS Bellary, Karnataka. 10,11 Most mothers died in the age group 20-24 years (49.2%). Majority of them were unbooked (60%) and multigravidae (55.8%).…”

Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital

“…Studies have shown that infants who lost their mother during childbirth are more likely to die before reaching their second birthday than infants whose mother survives. [3] In the present study, there were 62 maternal deaths out of 18,458 deliveries, presenting a maternal mortality ratio of 335 per 1,00,000 live births. This high maternal mortality can be attributed to the fact that the study was conducted in the tertiary care referral center.…”