Maternal mortality in a tertiary care teaching hospital

ABSTRACT

Every women can experience sudden and unexpected complications during pregnancy, child birth and just after delivery. Although high quality accessible health care has made maternal death a rare event in developed countries, these complications can often be fatal in the developing world. Safe motherhood as a priority for action can not be identified without properly assessing maternal mortality. The aims of this study were toanalyse the causes of maternal mortality and thus determine the preventable factors responsible for maternal deaths. Descriptive study. This study was carried out at DHQ Hospital Faisalabad from June 2002 to December 2004. Patients were admitted through emergency and Obstetrics and Gynaecology out-patient department. Patient age, parity, education, socio-economic status, antenatal booking level of care, whether come from rural or urban area, and distance from hospital were noted. Contributing and causative factors leading to maternal mortality were evaluated. All these information were recorded on a specially design Performa. Results: Total number of maternal deaths recorded during 2 V[2] years study period were 70. The causative factors of maternal mortality were sepsis 19[27%], post partum hemorrhage 18 [25.7%], eclan‡sia 11[15.7%], pulmonary embolism 7[10%], liver disease 6[8.5%] heart disease 5[7.1%], anaesthetic complications [3][4.2%] and one death [1.4%] due to miss match] blood transfusion in a private hospital. Patient's age ranged between 18-45 years. 40[57.1%] patients were <31 years old. 15[21.4%] patients were prmigravida or Para one and 55 [78.5%] were multigravida or multi para. All patients were unbooked, uneducated and belonged to poor socio-economic setup. Majority of them came from distance between 20-60 km. 40[57.1%] were attended by traditional birth attendant, 18 [25.7%] by lady health visitors, [3][4.2%] by doctors in private clinics and 9[12.8%] received no level of care. Sepsis, obstetrical hemorrhage, eclampsia and pulmonary embolism are major causative factors of maternal mortality