Discussion on a 5 Year Retrospective Study of Pattern of Maternal Mortality in a Tertiary Care Hospital in South India

Introduction: Maternal mortality remains one of the most daunting public health problems in India.
For every minute one mother is dying due to pregnancy and child birth related issues. A woman in
developing country has 30 to 40 times greater risk of dying due to pregnancy and child birth than her
counterpart in developed country. Even today 20% of global maternal deaths occur in India. The total
maternal deaths in India are around 63,000 a year, approximating one death every minute.
Materials and Methods: A retrospective analysis of 78 cases of maternal mortality over a period of 5
years from January 2007 to January 2012 in tertiary care hospital were analyzed with special
emphasis on parity, cause of death, time interval from admission.
Results: Hemorrhage was the leading cause of maternal death accounting for 26.92% followed by
sepsis 23.08%. Pre-eclampsia contributed to 20.51% of maternal death. Anemia was responsible for
17.95% deaths. The age group in which most (74.36%) maternal deaths occurred was 21-30 years
group. When the parity of the women was compared, it was seen that most maternal deaths was in
multi-para accounting for more than half the maternal deaths (56.41%).Most of the women (62.5%)
died within 24 hours of admission followed by many women dying in the next 24-48 hours being
12.5%.
Conclusion: The maternal mortality rate at referral hospitals in India is very high. Accurate estimation
of maternal mortality depends mainly on a sound vital registration system and proper reporting of
maternal death. Accurate estimation of maternal mortality depends mainly on a sound vital registration
system and proper reporting of maternal death. Solutions of the issues comprises of 3Ds: Delay in
diagnosis, immediate treatment and decision to transfer, delay in transport for reaching to proper
hospital and delayed therapy. Most of the deaths in our study have been avoided, if they had
registered and received proper antenatal care, early diagnosis, timely intervention and early referral
with well equipped transport facilities.