MATERNAL MORTALITY

AN ANALYSIS OF THE DETERMINANTS AND CAUSES

Abstract

Objective: The women residing in a developing country have 200 times greater risk of suffering from pregnancy and childbirth
related mortality compared with the women of a developed country. To investigate relevant causes and the determinants of maternal mortality
through conducting scientific clinical studies. Methodologies: We conducted a prospective study of maternal deaths in the obstetrics and
gynaecology unit of RGH for one year. Period: January 2007 to December 2007. We investigated the socio-demographic variables - including
age, parity, socio-economic status and literacy - along with the social behavior towards the antenatal. We designed standardized data collecting
forms to collect data from the confidential hospital notes of the patients. The collected medical data of the patients proved useful in analyzing
the underlying causes and the risk factors behind direct and indirect maternal mortalities. Results: In our unit, we have recorded 28 maternal
deaths during the study period. 24 (86%) deaths are due to the direct causes and 4 (14%) are due to the indirect causes. The leading direct
causes are hemorrhage 9 (37.5%), eclampsia 7 (29%), septicemia 5 (21%) and anaesthesia complications 2 (8%). Similarly, the distribution
of indirect causes is: blood transfusion reactions 2 (50 %), hepatic failure 2 (50 %), Consequently, crude maternal mortality rate can be
extrapolated at 645 per 100,000 maternities and maternal mortality ratio at 659 per 100,000 live births. The socio demographics of the dead
mothers are: 16 (57%) patients in the age group of 25-35 years, 13 (52%) are multiparas (G2-G4) and 10 (36%) are grandmulti para i.e. G5
and above. Moreover, 13 (46%) of them expired at term. The majority of them is illiterate and belongs to lower socio-economic group. 14 (42%)
mothers have not received antenatal care and just 4 (15%) of them have received antenatal care from RGH or other hospital. 23 (92%) patients
have been suffering from anemia and we received 15 (54%) of them in a critical state with the hospital stay of less than 12 hours. C o n c l u s i o n :
In our study hemorrhage and hypertensive disorders of pregnancy are the leading causes of maternal deaths. We argue that most of these
maternal deaths could have been possibly avoided by periodic interventions during the pregnancy, child birth and the postpartum period.