Autopsy study of maternal death in a tertiary care centre (original) (raw)

Causes of Maternal Mortality: Our Scenario

Journal of SAFOG, 2013

Objective To analyze the cases of maternal mortality over a period of 3 years with regard to direct, indirect and associated causes and social correlates. Materials and methods Retrospective evaluation of the cases with respect to causes, admission to mortality interval, age, parity, antenatal booking, socioeconomic status, etc. and systemic analysis of all contributing factors. Result and observation A total of 66.67% of the deaths were due to direct causes with obstetric hemorrhage being the most common cause followed by puerperal sepsis. Anemia was the most important indirect cause followed by hepatitis and cardiovascular diseases. Conclusion A large number of maternal deaths seem to be avoidable if we are able to strengthen our maternity and child health services. Equally important, however, remains the upgradation of the status of females in the society with emphasis on literacy and general health awareness. How to cite this article Soni M, Agrawal S, Soni P, Mehra H. Causes of...

An autopsy study of maternal mortality: A tertiary healthcare perspective

Journal of Postgraduate Medicine, 2009

Background: An audit of autopsies of maternal deaths is important for the establishment of accurate cause of maternal deaths and to determine the contribution of various etiologies responsible in a given community. Aim: To study the causes of maternal deaths as determined by a pathological autopsy. Settings and Design: A retrospective study of all the cases of maternal deaths that underwent a pathological autopsy in a tertiary healthcare center from January 1998 to December 2006. Materials and Methods: The autopsy records with clinical notes were retrieved; gross and histopathology specimens and slides were studied to establish the accurate cause of maternal deaths. The variables like age (years), stay in the hospital, gravidity, trimester of pregnancy and method of delivery were used to classify and analyze the data from the autopsies. The causes of maternal deaths were divided in to direct and indirect; each being classified into subgroups based on the most evident pathology on autopsy. Results: The Maternal Mortality Rate (MMR) over a nine-year period (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006) was 827/100000 live births (471 maternal deaths against 56944 live births). An autopsy was performed in 277 cases (58.8%). In the autopsy group, the most common causes of maternal mortality were pre-ecclampsia/ecclampsia (40 of 277, 14.44%) and hemorrhage (32 of 277; 11.55%); However, indirect causes like infectious diseases (27 of 277; 9.75%) and cardiac (27 of 277; 9.75%) disease also contributed to maternal deaths. Conclusion: Indirect causes like rheumatic heart disease and infections like tuberculosis, malaria or leptospirosis and nutritional anemia are still major causes of maternal mortality in developing countries like India. Intensive efforts need to be taken in these areas to reduce the maternal mortality in developing countries like India.

Analysis of causes of maternal mortality in tertiary care center, 11 years study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021

Background: Objectives to study the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study of hospital records and death summaries of all maternal death over a period of 11 years from January 2008 to December 2018 was carried out at tertiary care hospital, Mumbai.Results: There were a total of 459 maternal death out of 36930 live birth giving maternal mortality rate mean maternal mortality ratio (MMR) of 1242 per 100000 live births. Unregistered and late referral account for maternal death. The majority of women were in 21-30 years age group in 20 to less than 37 weeks of pregnancy. The commonest cause of death was due to hepatitis infection 129 (28.1%), sepsis 52 (11.32%), PIH including eclampsia 46 (10.02%), cardiovascular diseases 33 (7.18%), haemorrhage 31 (6.75%), Kochs 31 (6.75%) and respiratory diseases 22 (4.79%).Conclusions: Maternal mortality can be reduced by identifying causes which are preventable and giving timely tr...

Maternal mortality: a retrospective analysis of 6 years in a tertiary care centre

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017

Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labour or thereafter. Worldwide 3,03,000 women are dying of pregnancy related complication annually.Methods: The medical records of all maternal death occurred over a period of last five years between August 2011 to August 2017 in the Department of Obstetrics and Gynaecology at our tertiary care hospital were reviewed and analysed.Results: It is observed that out of total 30 patients, 24 (80%) deaths were from 20-30 year of age followed by 5 (16.67%) deaths from above 30 years of age. In the study period, 40% of maternal deaths were due to direct causes, haemorrhage (8/12; 66.67%) was main direct causes of obstetric death.Conclusions: The complications leading to maternal death can occur without warning at any time during pregnancy and childbirth. Most maternal deaths are preve...

A Retrospective Study of Maternal Mortality in A Tertiary Care Hospital

IOSR Journals , 2019

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.

Evaluate the Direct and Indirect Etiologies of Maternal Mortality: A Retrospective Analysis

International Journal of Medical and Biomedical Studies, 2020

Aim: prevalence and the various direct and indirect etiologies of maternal mortality. Materials and Methods: The present 1 years retrospective hospital based study was conducted in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Bhagalpur,Bihar,India Results: A total of 56 deaths were analyzed. The mortality rate in study period was 333 per 1,00,000 live births. Maximum maternal deaths (60.7%) were reported in the age group 21-25 years. More deaths were reported in multiparous women (67.9%) as compared to primiparous women (32.1%). Most of them were unbooked cases (60%). Hemorrhage (30.4%), eclampsia (16.1%), sepsis (12.5%) and embolism (7.1%) were the major direct causes of maternal death. Anemia (16.1%) was the major indirect cause of death. Conclusions: Hemorrhage is the leading cause of maternal death followed by hypertensive disorders and sepsis. Anemia continues to be the most common indirect cause. Majority of maternal deaths were p...

A comprehensive study on maternal mortality at a tertiary care hospital

IP innovative publication pvt. ltd, 2019

Introduction: Maternal mortality, according to WHO is defined as “the death of women while being pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of pregnancy, from any cause related or aggravated by the pregnancy but not from accidental or incidental cause”. Maternal death is classified as Direct and Indirect maternal death. About 99% ofMMRoccur in developing countries. Hence the present study has been taken up to analyze cause of maternal mortality in tertiary hospital. Aim: Our study aims to analyze the cause and incidence of maternal mortality in a tertiary care hospital Materials and Methods: Present Study is a, Retrospective study conducted in Cheluvamba hospital, MMC&RI which is a tertiary care hospital. We have analyzed all maternal deaths, which were reported in the institute during the study period starting from 1st January 2015 to 31st May 2019 (4 years 5 months). Results: There were 52,896 deliveries in our institute during the study period. 60 maternal deaths were reported. Maternal mortality rises with high degree of parity as noted in the study, multigravida (56.7%). 55% cases were unbooked. The major cause of death was attributed to Hypertensive disorders of pregnancy (45%) and second major cause is anemia (41.7%). Conclusion: Enhancing women’s access to basic health care facilities, regular Antenatal care, high risk pregnancy detection and its management and basic health education helps in reducing maternal mortality.

Maternal mortality at a tertiary health care: a retrospective study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of pregnancy from any cause related to or aggravated by the pregnancy, but not from accidental or incidental causes. The aim of this study is to find out the causes of maternal mortality and the complications leading to maternal death. Methods: A retrospective study was conducted by reviewing the hospital records to study the maternal deaths and complication leading to maternal death over the period of one year from July 2016 June 2017 in the Department of Obstetrics and Gynecology, Bundelkhand Medical College, and associated hospital Sagar, Madhya Pradesh. All the maternal deaths were scrutinized for various aspects likely to be related to death such as age, locality of residence, antenatal care, admission death interval and the cause of death. Results: The maternal mortality ratio in the present study is 292.33/100,000 live births. There were 28 maternal deaths out of 9578 live birth during the study period. The majority of deaths occurred in the 20-30 age group. hemorrhage (32.14%) and hypertensive disorders (14.28%) are two most common direct cause of maternal deaths. 42.85% of maternal deaths occurred within the first twenty-four hours of admission. Post-operative and post abortal sepsis, amniotic fluid embolism and pulmonary embolism are other direct causes. Indirect causes of maternal deaths account for 21.42%. Severe anemia was the leading indirect causes of maternal deaths. Conclusions: Hemorrhage, hypertensive disorders, and anaemia remain the major cause of maternal deaths. Delay in decision making, provision of treatment and referral to tertiary centre contributed higher maternal mortality. This requires more efforts to recognize the direct and indirect causes of maternal deaths.

Risk Factors of Maternal Mortality

Journal of Rawalpindi Medical College, 2014

Background: To analyze maternal deaths, the risk factors involved and the contribution of each risk factor towards maternal mortality. Methods: In this descriptive study a complete evaluation of all maternal deaths was performed. All maternal mortalities were presented and evaluated in monthly hospital mortality meetings. Information was collected about women booking status, age, parity, socioeconomic status, distance from place of referral, and reasons for delayed referral. Women who received antenatal care at least three times in the hospital were labeled as booked and rest of patients as non booked. The causes and factors leading to maternal deaths were recorded. Results:During this period total numbers of deaths certified were 51. Out of these 8 patients were brought dead to hospital while 43 died in hospital. Direct causes were found in 41 maternal deaths (80.3%). Hemorrhage being the leading cause (31.3%) followed by hypertensive disorders of pregnancy (eclampsia) and sepsis. ...

Analysis of Maternal Death in a Tertiary Care Hospital

Journal of Shaheed Suhrawardy Medical College, 2022

Objectives: Maternal death was analyzed in Shaheed Suhrawardy Medical College hospital to improve the quality of maternal health care. Methods: In this cross -sectional study, each case was reviewed individually and factors responsible for maternal death were identified and noted. Results: During the study period January 2019 to December 2019 total 16 maternal death recorded among 3410 deliveries. 68% deceased mother were less than 30 years of age. Parity shows 37.50% multipara. 75% deceased mother was delivered by caesarean section, 6% was vaginal delivery and 12.5% mother died undelivered. Regarding time interval 25% of death occurred within 24 hours of admission to hospital. The main causes of death were severe preeclampsia- eclampsia (31.25%), PPH (12.5%), septicemia (12.5%), DIC (12.5%). Some factors were identified and among them lack of proper ANC, delayed admission to hospital, delayed blood transfusion were related. Conclusion: Substantial number of maternal death occurred ...