A Retrospective Study of Maternal Mortality in A Tertiary Care Hospital (original) (raw)

Introduction: Maternal mortality is defined as the death of any woman while being pregnant or within 42 completed days of termination of pregnancy, irrespective of the duration or site of pregnancy, from any cause related to or aggravated by pregnancy, but not from accidental or incidental causes.1 Maternal mortality ratio (MMR) is defined internationally as the maternal mortality rate per 1 lakh live births. Materials and Methods: A retrospective hospital based study was conducted in the Department of OBG, M.G.M Medical College, Jamshedpur, India over a period of 2 years from January, 2017 to December, 2018. All booked or unbooked maternal deaths admitted at the time of pregnancy, delivery or during puerperium were included in study. The data was collected from hospital records. The medical records sheets of all identified women were reviewed regarding age, parity, residence, antenatal booking status and cause of maternal death. Data was collected on a proforma and entered into computer using SPSS version 10 for analysis. Permission of the institutional ethical committee was obtained before recording data on proforma with the assurance of its confidentiality. Causes of death were identified as direct cause and indirect cause. Results: A total of 53 deaths were analyzed. The mortality rate in study period was 441 per 1,00,000 live births. Maximum maternal deaths were reported in the age group 20-24 years. More deaths were reported in primiparous women (49.16%) as compared to multiparous women (35.83%). Most of them were unbooked cases (56.66%). The classic triad of haemorrhage (36.66%), hypertensive disorders (23.33%) and sepsis (12.5%) were the major direct causes of maternal death. Anemia was the major indirect cause of death. Other indirect causes of maternal death were jaundice, heart disease, respiratory disease and epilepsy. Conclusion: A number of sociodemographic factors affect maternal mortality. It was observed that poor, illiterate, unbooked women coming from remote rural areas were more vulnerable to morbidity and mortality. Haemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Death due to haemorrhage can be controlled by SBA training of all nursing staff. Death due to hypertensive disorders can be reduced by early identification of PIH, use of Magnesium sulphate and early termination of eclampsia.