Maternal Mortality at a Teaching Hospital of Rural India: A Retrospective Study

Abstract

Introduction: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labour or thereafter. Maternal death has serious implications on the family, the society and the nation. Maternal Mortality Ratio (MMR) is a very sensitive index that reflects the quality of health care provided by the country to the women population. Objectives: To assess the maternal mortality ratio and the causes of maternal death over a period of five years at a tertiary care teaching hospital of rural India. Methods: A retrospective hospital based study of 256 maternal deaths over a period of 5 years from January 2008 to December 2012. The information regarding demographic profile and reproductive parameters were collected and results were analyzed by using percentage and proportion. Results: Over the study period, there were 52413 deliveries, giving a MMR of 518.48 per 1,00,000 live births. The leading direct cause (81.64%) was Eclampsia (43.75%), while indirect (18.35%) leading cause was heart disease (6.64%). Most of the women (60.92%) died within 12 hours of admission suggesting majority patients reach the tertiary care hospital quite late. The age group of below 25 years (67.17%), primigravida (63.28%) and unbooked cases (89.84%) were mainly affected. Conclusions: Most maternal deaths are preventable by optimum antenatal, intranatal and postnatal care. Early referral, quick and well equipped transport facilities and promotion of overall safe motherhood is essential to reduce maternal deaths.