Maternal mortality at a tertiary health care: a retrospective study

Sona Singh, Nagendra Singh, Jagriti Kiran Nagar, Sarvesh Jain


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.


Anaemia, Hemorrhage, Hypertensive disorders, Maternal death

Full Text:



Abouzahr C, Wardlow T. Maternal mortality in 2000: estimates developed by WHO, UNICEF, UNFPA. WHO, Geneva, Switzerland. 2003. Available at;jsessionid=E01323B9B021728B0C383B71DB83DAF5?sequence=1

Rao KA. Presidential address. The 44th All India Obstetric and Gynaecological Congress, Ahmedabad. December 27, 2000. J Obstet Gynaecol India. 2001;51:25-8.

National Rural Health Mission: Framework for implementation 2005-2012; New Delhi: Ministry of Health and Family Welfare, Government of India. Available at

ACOG. ACOG Committee Opinion. Number 283, May 2003. New U. S. Food and drug administration labeling on cytotec (misoprostol) use and pregnancy. Obstet Gynecol. 2003;101:1049-50.

India’s Maternal Mortality Rate on a decline; may 27, 2017. Available at

IIPS. District level household and facility survey (DLHS-3) 2007–2008: India. Mumbai: International Institute for Population Sciences. Ministry of Health and Family Welfare Government of India. 2010. Available at

Barros AJD, Ronsmans C, Axelson H, Loaiza E, Bertoldi AD. Equity in maternal, newborn, and child health interventions in countdown to 2015: a retrospective review of survey data from 54 countries. Lancet. 2012;379:1225-33.

Campbell OMR, Graham WJ. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368:1284-99.

Jagdish JA, Govind RP. Maternal mortality: changing trends. J Obstet Gynecol. 2007;57:398-400.

Puri A, Yadav I, Jain N. Maternal Mortality in an urban tertiary care hospital of North India. J Obstet Gynae India. 2011;61:280-5.

Pathak D, Chakraborty B, Goswami S, Adhikari S. Changing trends of maternal mortality: a comparative study. J Obstet Gynaecol India. 2011;61(2):161-5.

Ashok V, Santosh M, Anupa S. A study on maternal mortality. J Obstet Gynecol. 2008;58:226-9.

Mundkur A, Rai L. Prepare and prevent rather than repair and repent, study of maternal mortality in tertiary care hospital. Int J Med Public Health. 2013;3:163-6.

Khumanthem PD, Chanam MS, Samjetshabam RD. Maternal mortality and it’s causes in a tertairy centre. J Obstet Gynecol India. 2012;62(2):168-71.

Konar H, Chakraborthy AB. Maternal mortality: a FOGSI study (based on institutional data). J Obstet Gynecol India. 2013;63(2):88-95.

Abha A, Arvind P, Bhattacharya BN. Risk factors for maternal mortality in Delhi slums: a community-based case control study. Indian J Med Sci. 2007;61:517-26.

Bedi N, Kambo I, Dhillon BS. Maternal deaths in India: preventable tragedies, (an ICMR task force study). J Obstet Gynecol India. 2001;51:86-92.