Affiliation:
1. Department of Obstetrics and Gynecology, Faculty of Manipal Academy of Higher Education, Kasturba Medical College,
Manipal, India
Abstract
Background:
The current United Nations sustainable development goal 3 sets to reduce
maternal mortality to less than 70 per 100 000 live births by 2030. To monitor whether India is on
track to attaining sustainable development goals, it is essential to routinely assess trends of health
indicators.
Objectives:
This study was conducted to assess trends of maternal mortality and cause-specific
maternal death in tertiary care hospitals in Southern India.
Methods:
This is a retrospective study of hospital records and death summaries of all maternal deaths
between January 1, 2009, and December 31, 2018, at the tertiary care hospital in Southern India. The
demographic, clinical, and delivery details of all the maternal deaths were collected. Causes of maternal
deaths were classified as direct, indirect, and nonspecific. To observe trends of maternal death, the
maternal mortality ratio was calculated for each year, and Pearson’s chi-square test was used.
Results:
Maternal mortality ratio was 555/100000 and had a decreasing trend from its highest in 2010
of 1230/100000 to its lowest of 229/100000 in 2017 (t = 7.71 p = 0.02). The majority of women who
died were aged 21-35 years, resided in rural, were primigravidae, and had operative delivery. Most of
the maternal deaths had been referred to our facility (90.8%) from other healthcare units. Obstetric
hemorrhage (27.8%) and puerperal sepsis (37.7%) among direct causes; H1N1 pneumonia (34.8%)
among indirect causes were the major causes of maternal death. The number of maternal deaths due to
sepsis increased from the beginning until the end of the study from 10% to 50% (t = 5.9, p = 0.01). On
the contrary, there was a decline in maternal deaths due to obstetric hemorrhage from 50% to 25% (t =
4.2, p = 0.03).
Conclusion:
Although the maternal mortality ratio has reduced over the years, sepsis was an
important cause of maternal deaths.
Publisher
Bentham Science Publishers Ltd.
Subject
Obstetrics and Gynecology