Facility Based Maternal Death Review And Study Of Delays In Maternal Mortality.

ABSTRACT

Objective: To evaluate various causes of maternal death and MMR at our institute and analysis of delays that contribute to maternal death. Methodology: This observational cross sectional study was conducted from January 2010 to December 2015 in Surat Municipal Institute of Medical Education and Research (SMIMER). All the maternal deaths of the institute during the study period were included in the study. A pre-structured coded Performa provided by National Rural Health Mission was used for present study. The factors associated with maternal deaths were classified by using the ‘three delays’ framework. Results: The overall MMR of the study was 244 per 100,000 live births. Direct obstetric causes were responsible in 68.04% cases of maternal death. Obstetric haemorrhage like antepartum haemorrhage (APH) and postpartum haemorrhage (PPH) were responsible in 24.74% of cases. Other important direct causes were septicaemia and eclampsia (10.30% and 9.27% cases respectively). Indirect causes were responsible in 31.95% cases of maternal death. Only 20.61% women had taken three or more ANC visits. 35.05% women had not taken any ANC care. 1st delay was found in 57.73% cases and 2nd delay in 34.02% cases. Conclusion: Maternal death review systems help to evaluate the trends of maternal deaths and help to develop subsequent policies and protocols to tackle life threatening obstetric emergencies.