Maternal mortality

摘要

Objectives: To estimate maternal mortality ratio (MMR), obstetrical causes and determinants of maternal mortality. Study Design: A descriptive study. Place & Duration of Study: The study was conducted in Obstetrics & Gynaecology Department at Bahawal Victoria Hospital, affiliated with Quaid-e-Azam Medical College, Bahawalpur. This was a 3 years study conducted from January 2006 to December 2008. Patients & Methods: All direct and indirect maternal deaths during pregnancy, labor and perpeurium were included. The patients who expired after arrival were analyzed on specially designed Performa from their hospital records and questions asking from their attendants. The reason for admission, condition at arrival, cause of death and possible factors responsible for death were identified. The other information including age, parity, booking status, gestational age and relevant features of index pregnancy, along with the distance from hospital was recorded on Performa and analyzed by SPSS version 11. Results: There were a total of 21501 deliveries and 19462 live births with 2039 peri-natal moralities. Total 133 maternal deaths occurred during last 3 consecutive years revealed MMR 683 per 100000 live births. Majority of the women who died were un-booked (91%). The highest maternal mortality age group was 20-30 years in which 54.2% deaths were observed. Out of 133 maternal deaths, 21% were primigravida. Obstetrical hemorrhage (44.4%) was the most frequent cause followed by hypertensive disorders (21.8%) & sepsis (15%). There were 33.8% of patients who were brought at compromised stage and 52.6% brought critical, only 13.5% died were stable at the time of arrival at hospital. Conclusions: Obstetrical haemorrhage was the leading cause of maternal deaths. This dreadful cause is preventable and manageable if steps are taken in time during antenatal period for risk detection and in postnatal period. Community awareness, training of traditional birth attendants to recognize the severity of disease and importance of being in time and improving referral can reduce the maternal deaths