Maternal mortality unveiled: insights from a tertiary care hospital in western India

Abstract

Background: Maternal mortality remains a significant public health issue, especially in resource-constrained settings. Despite national and global efforts, India still contributes substantially to the global maternal death burden. Objectives were to evaluate patterns along with socio-demographic and clinical factors linked to maternal mortality, and to analyze types of delay that contribute to maternal deaths.

Methods: This cross-sectional study was conducted in the obstetrics and gynaecology department of tertiary care center, from March 2023 to August 2024. All maternal deaths during this period (n=47) were analyzed. Data were extracted from case records and analyzed using descriptive statistics. The maternal mortality ratio (MMR) was calculated per 100,000 live-births.

Results: Total 47 maternal deaths were reported among 12,356 live births, giving an MMR of 380.38. Most deaths occurred in the 20-30-year age group (74.46%), among illiterate (72.34%) and rural (59.57%) women. More than half of the maternal deaths (57.44%) were in multigravida and in unregistered cases (57.44%). 68.1% of women were referred from other centres, often critically ill. A significant number of women died [33 (70.21%)] during postnatal period of pregnancy. Hemorrhage (43.3%), sepsis (33.3%), and hypertensive disorders (23.3%) were the leading direct causes. Indirect causes included heart and nervous system disorders. Type 1 delays (59.6%) were the most common, followed by type 3 (27.7%).

Conclusions: Adequate and quality antenatal care, early identification of high-risk pregnancies, and strengthening referral systems are crucial. A multifaceted approach including health education, infrastructure improvement, and continuity of care is necessary to reduce maternal mortality.