DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20151629

A cross sectional study to assess the pattern of maternal mortality in a tertiary level government hospital of a city in north India

Akanksha Lamba, Sakshi Agarwal, Apurba Kumar Dutta

Abstract


Background: The index of the quality of health care delivery system of a country is reflected by its maternal mortality rate (MMR). Epidemiological data pertaining to maternal mortality is valuable in each set up to design interventional programs to favourably reduce the same. The objective of our study was to evaluate the maternal mortality rate in a tertiary care hospital, to assess the epidemiological aspects and causes of maternal mortality.

Methods: A retrospective study of hospital records and death summaries of all maternal deaths over the period from January 2010 to December 2012 was carried out. Maternal mortality rate, epidemiological factors and causes affecting maternal mortality were assessed.

Results: A total of 45 maternal deaths occurred per 7,266 live births out of which unbooked and late referrals accounted for 75.55 % of maternal deaths. Most maternal deaths occurred in the age group of 20–30 years, multiparous women (73.33%) and women from rural areas (71.11%). Direct obstetric causes accounted for 82.22% of maternal deaths where as 15.55% of maternal deaths were due to indirect causes. Maternal mortality rate (MMR) came out to be 627.79 per 100,000 live births. Hemorrhage was the commonest cause of death (37.33 %), followed by pregnancy-induced hypertension including eclampsia (15.55 %) and sepsis (11.11%).

Conclusions: Hemorrhage, sepsis, and pregnancy-induced hypertension including eclampsia were found to be the direct major causes of death. There is a wide scope for improvement as a large proportion of the observed deaths are preventable.


Keywords


Maternal mortality rate, Postpartum hemorrhage, Sepsis, Eclampsia, Anemia

Full Text:

PDF

References


Maternal mortality. Website accessed by authors. http://www.icm.tn.gov.in/intersession/ Matnal.html.

Special Bulletin on Maternal Mortality in India 2007-09: Sample registration system, Office of Registrar General, India, 2011.

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

Bhat PN, Navneetham K, Rajan SI. Maternal mortality in India: estimates from a regression model. Stud Fam Plann. 1995;26:217-32.

Registrar General of India. Maternal mortality in India: 1997–2003. Trends, causes and risk factors, Report 2006, Registrar General India: New Delhi.

United Nations. UN Millennium Development Goals web site. http://www.un.org/millenniumgoals/. Accessed 1 August 2009.

Paul B, Mohapatra B, Kar K. Maternal deaths in a tertiary health care centre of Odisha: An in-depth study supplemented by verbal autopsy. Indian J Community Med. 2011;36:213-6.

Nour NM. An Introduction to Maternal Mortality. Reviews in Ob Gyn. 2008;1:77-81.

India leads with Highest Maternal and First day Infant Deaths. Latest Current Affairs Questions. Retrieved 12 May 2013.

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.

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

Bates I, Chapotera G, McKew S. Maternal mortality in sub-Sahara Africa: the contribution of ineffective blood transfusion services. BJOG. 2008;115:1331-9.

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