Published: 2021-02-24

Maternal death audit at tertiary care centre: changing trends

Sudha Sivakumar, Sophia G. Xavarina, Ashmitaa Srianand


Background: The aim of the study was to analyse the trend in maternal mortality ratio in a tertiary care centre.

Methods: This was a four-year retrospective analysis of maternal deaths that occurred at Government Rajaji Hospital, Department of Obstetrics and Gynaecology, Madurai from January 2017 to December 2020. Cases were stratified based on cause of death. Epidemiological data was collected from the hospital register.

Results: The total number of maternal deaths at GRH during the study period is 228, in which death due to obstetric cause was 82 (36%) and non-obstetric cause was 146 (64%). The most common cause in each year was PIH (23%-2017, 29%- 2018), heart disease (22%- 2019) and infection (46%- 2020).

Conclusions: We concluded by this study that the maternal death due to non-obstetric causes were more than the obstetric causes due to improved antenatal, post-natal care, institutionalized deliveries and timely referral to the CEmONC (comprehensive emergency obstetric and new-born care) centres and management.


Haemorrhage, Heart disease, Maternal mortality ratio, Pregnancy induced hypertension, Sepsis

Full Text:



World Health Data Platform. GHO, Indicator Metadata Registry List. Maternal mortality ratio (per 100 000 live births). Available at: Accessed on 4 October 2020.

Patwardhan M, Eckert LO, Spiegel H, Pourmalek F, Cutland C, Kochhar S, et al. Maternal death: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2016;34(49):6077.

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

WHO, UNICEF, UNFPA, World Bank, United Nations. Trends in maternal mortality: 1990 to 2013. Geneva: World Health Organization; 2014.

Kulkarni Sunanda R, Huligol A, Maternal mortality: 10 years study. J Obstet Gynaecol India. 2001;51:73-6.

Shrivastav S. Maternal mortality rate among worst in India, TNN. 2011.

Bedi N, Kambo I, Dhillon BS, Saxena BN, Singh P. Maternal deaths in India- preventable tragedies (An ICMR-Task Force Study. J Obstet Gynaecol India. 2001;51:86-92.

SRS Bulletin- MMR. Available at: Accessed on 10 October 2020.

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

Ministry of Women and Child Development/ Reduction in maternal mortality. Available at: Accessed on 10 October 2020.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-33.

Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):980-1004.

Lim SS, Dandona L, Hoisington JA, James SL, Hogan MC, Gakidou E. India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. Lancet. 2010;375(9730):2009-23.

Dutta DK. Strategies to reduce maternal mortality and morbidity in Rural India. The Federation of Obstetrics and Gynecological Society of India. Available at: Accessed on 10 October 2020.