An overview of maternal mortality in a tertiary care hospital from September 2017 to August 2018
Dr. S Lavanya Kumari, Dr. Poonam Chaganti
Background: Maternal mortality is one of the indices of health care in every country. It is estimated globally that, every 5 minutes a mother dies due to complications of pregnancy or labour and 15% of women develop life threatening complications. Approximately 17% of the maternal deaths occur in India. India has registered significant improvement in reducing MMR from 167 in 2011-2013 to 130 (per 100,000 live births) in 2014- 2016, according to new data released by registrar general of India. Methods: It is a retrospective study carried on maternal deaths from September 2017 to August 2018 in Government General Hospital, Kakinada. A self-designed questionnaire was formulated and the causes of death were delineated. Results: A total of 67 maternal deaths have occurred from September 2017 to August 2018. 40 cases (85%) were referred from periphery. Of 67 cases, 27 (41%) had risk factor awareness but refused admission. Of those 9(33%) cases were booked at private hospitals, 16(59%) cases were booked at other government hospitals and 2 (8%) were booked at GGH. 38(56%) were delivered by caesarean section, 12(17%) cases were delivered by vaginal route in our hospital, 3(4%) cases were abortions. 4 (5%) cases were delivered outside by cesarean section and were referred here due to post-operative complications. Most recurrent indication for cesarean section was hypertensive disorders of pregnancy 21(55%) cases, post caesarean pregnancy 8(21%), abnormal presentations 8(21%), placenta previa 1 case. Conclusion: Preeclampsia and eclampsia were the leading cause of death followed by anemia, hemorrhage and other indirect causes include sepsis, medical and surgical disorders. Preventing maternal death begins with pre conceptional management; good antenatal, intrapartum and postpartum care, early identification and management of anemia, hypertension and hemorrhage and health education.