Maternal Mortality Rate, Risk Factors and Causes

Objective: Purpose to conduct this study was to determine maternal mortality rate, its causes and associated risk factors. Place and Duration: This study was conducted in Gynecology and Obstetrics Unit of Shifa international hospital Islamabad Pakistan from January 2017 to December 2017. Design of Study: It was a descriptive study. Patients and Methods: This study was conducted on the Obstetric patients admitted in Gynae ward via OPD and emergency bases during one year period. Total 1550 deliveries took place during this period and out of them 44 maternal deaths were recorded due to various causes. A predesigned proforma was used to document all necessary data of individual patients. At the time of presentation age, parity, previous history of still birth or abortion, mode of admission and history of previously mode of delivery either cesarean or vaginal delivery, eclempsia, hemorrhage, sepsis, obstructed labour, Anemia, othermorbidities like renal failure or heart disease all data was documented on the proforma. A written consent was taken from all the patients for including them in the study. Proper consent was also taken from the Medical superintendant of the hospital. All laboratory investigations and ultrasound were done from within the hospital. These patients were monitored continuously. Results: During study period 1550 deliveries conducted in gynae. and obs. ward of the Hospital. Out of them 44 mothers died due to various reasons. Maternal mortality rate was 28 per 1000 live births. Age range of these cases was 16-38 years with mean age of 18.5 years. Most of the cases 38.6% were having age of 26-30 years, 20.4% were in age group of 15-20 years, 27.2% with age of 21-25 and 13.6% mothers were above 30 years of age. Most common cause of mortality among mothers was eclempsia 25% followed by other causes such as hemorrhage 22.7%, sepsis 18%, obstructed labour 13.8%. These all were direct causes of mortality. Indirect causes include Liver disease 6.8%, anemia 9.1% and renal failure in 4.5%. Most of these cases had history of previous C-section single or multiple times in 50%, spontaneous vaginal delivery in 34% and still birth in 9% cases. Most of these mothers 45.4% were having 1-2 parity, 31.8% with zero parity and 22.7% with 3-4 parity. Conclusion: There is high rate of maternal mortality in underdeveloped countries. Major risk factor is eclempsia followed by hemorrhage, sepsia and obstructed labour. Proper antenatal follow-up, proper history taking and thorough examination with vital monitoring can reduce the rate.