Published: 2021-01-28

Maternal mortality in a tertiary care hospital: a 3-year retrospective study

Harish K. M., Shwetha N., Nalini N.


Background: Systematic review to determine the epidemiological aspects and causes of maternal mortality there by exploring possibility of intervention and implementing Evidence-based health policies and programmes to prevent future maternal death. Aims and objectives of the study were to calculate the maternal mortality rate in our hospital, to assess the epidemiological aspects of maternal mortality, to assess the type of delay and causes of maternal mortality and to suggest ways to reduce the MMR.

Methods: This is a 3-year retrospective study from January 2017 to December 2019 that will be conducted in the department of obstetrics and gynaecology, The Apollo medical college and District hospital, Chittoor a tertiary care teaching hospital situated in the southernmost part of Andhra Pradesh state in India. It gets a large number of referrals from PHCs, CHCs, and maternity homes as well as from hospitals across Chittoor district. Epidemiological data will be collected from the hospital register. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality are assessed.

Results: MMR in present study was 66 per 1,00,000 live births. Women in the age group of 20 to 30 years (85.72%), illiteracy (57.16%) and low socioeconomic status (100%) were risk factors for maternal mortality. Obstetric haemorrhage (57.16%) is most common cause whereas type 1 and type 2 delays are most common contributing factors for maternal mortality.

Conclusions: Early identification and management of pregnancy complication, strengthening of existing Emergency obstetric care (EmOC) facilities, easy transport and appropriate referral linkages are keys to reduce maternal mortality to further extent.


Maternal mortality ratio, Maternal mortality, Prevention

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Department of health and family welfare, Govt of India. Maternal and adolescent healthcare. Annual Report 2017-2018. 2020;27.

Word Health Organization. Maternal mortality. Geneva, Switzerland: Word Health Organization; c2019. cited at 2019. Available from: Accessed on 10 Oct, 2020.

Department of health and family welfare, Govt of India. Maternal and adolescent healthcare. Annual Report 2019-2020. 2020;25.

United Nations General Assembly. United Nations Millennium Declaration. A/RES/55/2. 1-9-2000. UN General Assembly, 55th session, agenda item 60(b). 2000.

Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019. J Family Med Prim Care. 2019;8:1864-9.

World Health Organization. The WHO Application of ICD-10 to Deaths During Pregnancy, Childbirth and the Puerperium: ICD-MM. WHO, 2012.Google Scholar. Available at: reproductivehealth/publications/monitoring/9789241548458/en/. Accessed on 10 November 2020.

World Health Organization, International Classification of Diseases, 10th Revision (ICD-10). Geneva, Switzerland World Health Organization 1992. Available at: occupational_health/publications/en/oehicd10.pdf?ua=1. Accessed on 10 November 2020.

Government of India. Special bulletin on maternal mortality in India 2016-18: Sample registration system. Government of India. Retrieved September 24, 2020, from Accessed on 10 Oct, 2020.

Juneja Y, Rai U. A five years review of maternal mortality. J Obstet Gynecol India. 1993;43:944-9.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels JD, et al. Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health. 2014;2(6):323-33.

Nove A, Matthews Z, Neal S, Camacho AV. Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries. Lancet Glob Health. 2014;2(3):e155-64.

Muniro Z, Tarimo CS, Mahande MJ, Maro E, Mchome B. Grand multiparity as a predictor of adverse pregnancy outcome among women who delivered at a tertiary hospital in Northern Tanzania. BMC Pregnancy Childbirth. 2019;19(1):222.

Haile A, Enqueselassie F. Influence of women’s autonomy on couple’s contraception use in Jimma town, Ethiopia. Ethiop. J Health Dev. 2006;20(3):145-51

Murthy BK, Murthy MB, Prabhu PM. Maternal Mortality in a Tertiary Care Hospital: A 10-year Review. Int J Prev Med. 2013;4(1):105-9.

Doddamani U, Rampure N, Kaveri, Pooja. A study of maternal mortality in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2018;7:2446-8.