Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

Darshna M. Patel, Mahesh M. Patel, Vandita K. Salat


Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.

Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.

Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.

Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.


Anemia, Maternal mortality ratio, Postpartum haemorrhage

Full Text:



World health organization. ICD-10: international statistical classification of diseases and related health problems. Geneva: world health organization; 1992.

Buekens P. Is estimating maternal mortality useful? Bull world health organ. 2001;79(3):179.

Special Bulletin on Maternal Mortality in India 2011-13: Sample registration system, Office of Registrar General, India. Accessed 02 January 2018.

Ronsmans C, Graham WJ. Maternal mortality: who, when, where, and why. Lancet. 2006;368:1189-200.

Thaddeus S, Maine D. too far to walk: maternal mortality in context. Soc Sci Med. 1994;38:1091-110.

Puri A, Yadav I, Jain N. Maternal mortality in an urban Tertiary care hospital of north India. J Obstet Gynaecol India. 2011;61:280-5.

Jain M, Maharahaje S. Maternal mortality: A retrospective analysis of ten years in a tertiary hospital. Indian J Prev Soc Med. 2003;34:103-11.

Jadhav AJ, Rote PG. Maternal mortality–changing trends. Obstet Gynaecol India. 2007;57:398-400.

Pal A, Ray P, Hazra S, Mondal TK. Review of changing trends in maternal mortality in a rural medical college in west Bengal. J Obstet Gynecol India. 2005;55:521-4.

Onakewhor JU, Gharoro EP. Changing trends in maternal mortality in a developing country. Niger J Clin Pract. 2008;11:111-20.

Shah RJ, Ali I, Banday A, Fazili A, Khan I. Analysis of maternal mortality in a small teaching hospital attached to tertiary care hospital. Indian J Community Med. 2008;33:260-2.

Iqbal M, Muhammad Z, Akhtar Z, Naz T. The three delays of maternal mortality in a teaching hospital. J Med Sci. 2017;25(2):231-5.