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

Authors

  • Rajarajeswari R. Department of Obstetrics and Gynaecology, Raja Mirasudar Hospital, Thanjavur Medical College, Thanjavur, Tamilnadu, India
  • Poovathi M. Department of Obstetrics and Gynaecology, Raja Mirasudar Hospital, Thanjavur Medical College, Thanjavur, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20163855

Keywords:

Haemorrhage, Hypertensive disorders complicating pregnancy, Maternal mortality ratio, Maternal death audit

Abstract

Background: Maternal mortality is a human development indicator. Maternal deaths have serious implication on the family, society and nation. This study is aimed to study the determinants, common causes and recommendations for the prevention of possible causes of maternal mortality.

Methods: A retrospective observational study of all maternal deaths for one year period from August 2014 to July 2015 was done in the Department of Obstetrics and Gynaecology, Raja Mirasudhar Hospital, Thanjavur Medical College, Thanjavur, Tamilnadu, India.

Results: Over the study period there were 29 maternal deaths out of 14898 deliveries with 14220 live births amounting to a maternal mortality ratio of 204 per 100000 live births. Hypertensive disorders complicating pregnancy were the leading causes of maternal mortality amounting to 40%, while others were haemorrhage - 31%, anaemia with failure 17.2%, heart disease complicating pregnancy 6.4%, sepsis 3.2% and other causes 3.2%. Out of 29 maternal deaths 64.3% were in the age group 21-30 years and 75.7% belonged to lower socio economic status.

Conclusions: The Maternal mortality ratio in our study was 204 per 100000live births. Of these the Maternal Mortality Ratio due to intramural deaths was 70 per 100000 live births and Maternal Mortality Ratio due to extra mural deaths (late referral) was 134per100000live births. Hypertensive disorders complicating pregnancy (40%) and its complications mainly HELLP (72.7%) and eclampsia (37.3%) were the most common cause of maternal deaths. Facility based maternal death review and State based maternal death review has contributed a lot in the analysis of the factors causing and compounding maternal mortality and reduction of maternal mortality and its ratio in Tamilnadu.

References

Health Statistics and Information systems WHO 2015. Available from http://www/who.int/healthinfo/statistics/indmaternalmortality/en/. Last accessed on August 23, 2015.

Government of India. Maternal Mortality in India 2011-2013. New Delhi; Registrar General, India 2013.

WHO, UNICEF, UNFPA, the World Bank. Trends in Maternal Mortality; 1990 to 2010. WHO, UNICEF, UNFPA and The World Bank estimates. Geneva; WHO, UNICEF, UNFPA; 2012.

Government of India. Maternal Mortality in India 2012-2014. New Delhi; Registrar General, India 2014.

NRHM - SHS - TN - Proc. No.6326/P5/SHS/2013. RCH - PIP 2014, Ministry of Health and Family Welfare, Maternal Death Review - Pb nrhm.org/docs/mdr.pdf.

Dumont A, Gaye A, Landry A. FBMDR: effects on Maternal Mortality in a District Hospital in Senegal. Bull WHO. 2006:84:218-24.

Lewis G. Beyond the numbers: reviewing Maternal Death and complications to make pregnancy safer. Br. Med Bull. 2003;67:27-37.

Tayade S, Bagde M, Shivkumar P, Tayade A, Bagde N. Maternal Death Review to know the determinants of Maternal Mortality in a District Hospital of Central India, Internet Dig of Biomed Res. 2012:3(3).

Rajaram P, Agarwal A, Swain S. Determinants of Maternal Mortality: a hospital based study from South India. Indian Journal of Maternal and Child Health. 1995;6(1):7-10.

Bedi N, Kambo I, Dhillon BS. Maternal Death in India - Preventable Tragedies (An ICMR Task Force Study. J Obstet Gynecol. 2001;51(2):86-92.

Kongnyuy EJ, M lava G. FBMDR in 3 districts in Central Region of Malawi; an analysis of causes and characteristics of Maternal Death. Women’s Health. 2009;19(1):14-20.

Vidhiyadhar B, Purushottam A, Giri B, GargRc. Maternal Mortality at a tertiary care teaching hospital of rural India, a retrospective study. Int J Biool Med Res. 2001;2(4):1043-6.

Murthy BK, Murthy MB, Prabhu PM. Maternal Mortalityin a tertiary care hospital: A 10 – year review. Int J Prev Med. 2013;4:105-9.

Boro RC, Sarma P, Acharjee PS. Causes of maternal deaths at Tezpur Medical College and Hospital (TMCH), Tezpur, Assam, India: a retrospective study. Int J Reprod Contracept Obster Gynecol. 2016;5:1006-9.

Lal R, Lal S, Mandal A. Births Should not cause deaths: A retrospective analysis of Maternal Mortality at a Tertiary care Hospital in Eastern India. Int J of Scientific study. 2015;3(8):67-70.

Sultan S, Kumar A, Bhagchandani D. Analysis of Maternal Mortality in Tertiary Care Centre: A retrospective study. J of Evolution of Medical and Dental Sciences. 2013;2(11):1728-35.

Goswami KD, Dudhrejia KM, Parmar PH, Kataria A. An analytical study of Maternal death at Tertiary Care Hospital. Int. J Med Res Rev. 2015;3(9):1008-11.

Distribution of Maternal and Neonatal Deaths India 2011-13 - MMR Bulletin 2011-13, Registrar General of India - Sample Registration System.

NRHM Guidelines. Availbale from: www.nrhm.gov.in/nrhmcomponents/reproductive child health/ maternal health.htm /SBA guidelines.

Gopalan S, Ratnakumar S, Jain V. Mudaliar and Menon’s Clinical Obstetrics. 12th edition editors. 2011. pp. 469-73.

Mukherjee S, Theengh C, Bhattacharya S, Maru I. Maternal Mortality at a tertiary care institute of Central India. Asian J of Obst Gynec. 2010;4:23-7.

Puri A, Yadav I, Jain N. Maternal Mortality in an urban tertiary care hospital of North India. Indian J of Obst Gynecol. 2011;61(3):280-5.

Pal A, Prasantha R, Samir H, Mondal TK. Review of changing trends in material mortality in a rural medical college of West Bengal. J Obst Gynecol Ind.2005;55(6):521-4.

Arpita N. A retrospective and prospective study of maternal mortality in a rural tertiary care hospital of Central India. Indian J of community Health 2013;25:1.

Verma A, Minhas S, Sood A. A study on maternal mortality in Dr. Rajendra Prasad Govt. M.C. Tanda Dist. Kangra, HP. Indian J Obst Gynecol. 2008;58(3):226-9.

Antepartum Haemorrhage, Clinical Green top guidelines No.63. The Royal College of Obstetricians and Gynecologists. Nov 2011.

Comstock CH. Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol. 2005;26:89-96.

Gopalan S, Ratnakumar S, Jain V. Mudaliar and Menon’s Clinical Obstetrics. 12th edition editors. 2011. pp. 413-18.

Farquhar C, Sadler L, Masson V. et al Beyond the numbers: classifying contributory factors and potentially available maternal death in New Zealand. 2006-09. AMJ Obstet Gynecol. 2011:205:331.el.8.

Sandhu AK, Mustafa FE. Maternal Mortality in Bahrain 1987-2004, an audit of causes of avoidable death. East Mediter Health J. 2008;14(3):720-30.

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Published

2016-12-14

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Original Research Articles