RESUMEN
This is a prospective, descriptive, hospital-based study, to determine maternal mortality ratio with regard to obstetric hemorrhage in Khartoum from first of January 2007 to 30th of June 2008. Maternal deaths were immediately reviewed in all maternity units in Khartoum state hospitals. Causes of death were diagnosed on clinical grounds; autopsy was done only for three medico-legal cases. There were 130 maternal deaths reported out of 105210 live births; maternal mortality ratio is 124/100000 live births, 107 cases [82.3%] were due to direct obstetric causes, while 23 cases [17.7%] were from indirect causes. Obstetric hemorrhage was the main direct cause of death 29.2%, 76.3% due to post partum hemorrhage, it affects low risk groups, only 21% were grand-multiparae and 68.8% had no significant abnormal obstetric history, 42.1% did not present with hemorrhage, and 39.5% had no blood transfusion Most of patients [68.4%] died within first 24 hours from admission. This study showed that home delivery, late consultation, suboptimal intra-partum or intraoperative care, late intervention, unavailability of blood or blood substances and poor referral system are the main factors behind maternal deaths