A study of maternal mortality due to non-obstetric causes

Tejal N. Kansara, Tushar M. Shah, Foram R. Lalcheta


Background: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times mortality, due to various complications that may arise during pregnancy, labour or thereafter. The existing medical condition, infection, and surgical condition which is collectively called as non- obstetric cause pre disposes a women for more complication than a non-pregnant women, so much so that it can lead to maternal mortality. Thus, Pregnancy is more vulnerable state and present study was carried out to study, analyse and review various non-obstetrics causes of death of women during pregnancy or within 42 days of termination of pregnancy in Tertiary care centre.

Methods: This was an Observational study, conducted in the department of obstetrics and gynaecology, at a tertiary care hospital attached with medical college, from October 2016 to October 2018. The details of maternal deaths were collected from various departments with non- obstetric causes and analyzed.

Results: The total number of deliveries in my study period was 15,208. There were 197 maternal mortality in our study period, of which 51 women died of non-obstetric causes. The most common cause of maternal mortality in our study was hepatic cause i.e. 33.33% amongst which viral hepatitis was the most common cause followed by respiratory (19.60%), infectious (15.18%), heamoglobinopathy (13.72%), cardiac (5.88%), neurological (5.88%), surgical (5.88%) causes.

Conclusions: Looking into our study, maternal mortality can be reduced by identifying various different indirect medical causes which are preventable by proper pre-pregnancy evaluation for pre-existing comorbid conditions.


Live births, Maternal mortality, Non-obstetric cause, Rural population, Viral hepatitis

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World Health Organization. Trends in maternal mortality: 1990 to 2008. Available at: Accessed August 7, 2011.

WHO. International classification of diseases and related health problems, 10th revision. Geneva: World Health Organization. 1992.

United Nations Development Programme. Millennium Development Goals. Available at: Accessed August 7, 2011.

Puri A, Yadav I, Jain N. Maternal mortality in an urban tertiary care hospital of North India. The J Obstet Gynecol India. 2011:280-5.

Blanc AK, Winfrey W, John R. New findings for maternal mortality age patterns: aggregated results for 38 countries. PLoS One. 2013;8(4):e59864.

Mahala U, Prakash O, Mehta S, Sharma M. Maternal mortality at tertiary care hospital in Rajasthan: a 10 - year review. IOSR J Dent Med Sci. 2017;16(6):89-92.

Bellad MB, Vidler M, Honnungar NV, Mallapur AS, Ramadurg U. Maternal and newborn health in Karnataka State, India: the community level interventions for preeclampsia (CLIP) trial's baseline study results. PLOS ONE. 2017;doi:10.1371/journal.pone.0166623.

Montgomery AL, Ram U, Kumar R, Jha P. The million death study collaborators maternal mortality in India: causes and healthcare service use based on a nationally representative survey. PLoS ONE. 2014;9(1):e83331.

WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Trends in maternal mortality: 1990 to 2015. WHO /RHR/15.23. The Lancet. 2015. Available at: S0140-6736(15)00838.

Bangal VB, Giri PA, Garg R. Maternal mortality at a tertiary care teaching hospital of Rural India: a retrospective study. Int J Biol Med Res. 2011;2(4):1043-6.

Nair M, Choudhury MK, Choudhury SS, Kakoty SD, Sarma UC, Webster P, et al. Association between maternal anaemia and pregnancy outcomes: a cohort study in Assam, India. BMJ Glob Health. 2016.

Beniwal M, Kumar A, Kar P, Jilani N, Sharma JB. Prevalence and severity of acute viral hepatitis and fulminant hepatitis during pregnancy: a prospective study from north India. Indian J Med Microbiol. 2003;21:184-5.

Rasheeda CA, Navaneethan U, Jayanthi V. Liver disease in pregnancy and its influence on maternal and fetal mortality: a prospective study from Chennai, Southern India. Eur J Gastroenterol Hepatol. 2008;20:362-4.

Patra S, Kumar A, Trivedi SS, Puri M, Sarin SK. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med. 2007;147:28-33.

Rojas-Suarez J, Paternina-Caicedo A, Cuevas L, Angulo S, Cifuentes R, Parra E. Maternal mortality due to pandemic influenza A H1N1 2009 virus in Colombia. J Perinat Med. 2014;42(1):19-26.