Patterns and causes of maternal mortality in tertiary care hospital in Maharashtra, India: a 10-year retrospective study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20232427Keywords:
Causes, India, Maternal mortality, Pattern, Tertiary care hospitalAbstract
Background: Maternal death is a catastrophe, as death of a mother can the entire family. The aim of present study is to find out major patterns, reasons and complications leading to maternal deaths.
Methods: A retrospective study was conducted for last 10 years from January 2013 to December 2022 by studying the records of a tertiary care hospital to study the maternal mortalities and complications leading to death. Maternal deaths were analyzed by considering different facets, such as age at death, gravida, locality of residence, admission death interval and direct and indirect cause/s of death, etc.
Results: During the study period, total of 107753 live births and 202 maternal deaths have been recorded. The average maternal mortality rate of last ten years was 187.46/100000 live births. Age wise maternal mortality during the study period was high in the age 19 to 25. Major direct cause of maternal mortality was postpartum hemorrhage, (23%) and major indirect cause observed was anemia (43%). Admission to death interval time indicates that delay in provision of treatment and referral to tertiary care hospital might be the reason responsible for high maternal deaths.
Conclusions: Maternal deaths can be prevented by improving the health care facilities, ensuring skilled attendants and required basic medication. This is high time to mobilize universal, national, regional, and community-based commitment to decrease maternal mortalities.
References
WHO. Evaluating the quality of care for severe pregnancy complications: The WHO near miss approach for maternal health. Geneva: World Health Organization; 2011. Available at: https://www.who.int/publications/i/item/9789241502221. Accessed on 24 May 2023.
Magar JS, Rustagi PS, Malde AD. Retrospective analysis of patients with severe maternal morbidity receiving anaesthesia services using'WHO near miss approach'and the applicability of maternal severity score as a predictor of maternal outcome. Ind J Anaesth. 2020;64(7):585-93.
Das R, Biswas S, Mukherjee A. Maternal mortality at a teaching hospital of rural India: a retrospective study. IJBAR. 2014;05(02):114-7.
Bedi N, Kambo I, Dhillon BS, Saxena BN, Singh P. Maternal deaths in India: Preventable tragedies (An ICMR task force study). J Obst Gynaecol Ind. 2001.51:86-92.
Priya N, Ashok V, Suresh V. Maternal mortality: Ten years retrospective study. JK Sci. 2010;12(3):134.
Bwana VM, Rumisha SF, Mremi IR, Lyimo EP, Mboera LEG. Patterns and causes of hospital maternal mortality in Tanzania: A 10-year retrospective analysis. PLoS ONE. 2019;14(4):e0214807.
Braund S, Leviel J, Morau E, Deneux- Tharaux C, Verspyck E, ENCMM study group. Maternal sudden death: A nationwide retrospective study. BJOG. 2023;130(3):257-63.
Singh S, Singh N, Nagar JK, Jain S. Maternal mortality at a tertiary health care: a retrospective study. Inter J Reprod Contracep Obstet Gynecol. 2018;7(5):1773-8.
Deb D, Das AK, Kameswari B, Sarkar AP. Changing trends of maternal mortality in a rural medical college in Eastern India: a 23-year retrospective study. J Clin Diag Res. 2022;16(10):10-11.
Lal R, Lal S, Mandal A. Births should not cause deaths: a retrospective analysis of maternal mortality at a tertiary care hospital in Eastern India. Inter J Sci St. 2014;2(8):67-70.
Gupta N. Changing trends in maternal mortalities rates-a retrospective study of 20 years at a tertiary teaching hospital of Uttar Pradesh. South Asian Fede Obstet Gynecol.2009;1(2):14-8.
Mukherjee S, Mukherjee S, Sarkar R. A six-year retrospective study of maternal mortality at a tertiary teaching institute in Uttar Pradesh. Inter J Med Sci Pub Heal. 2014;3(11):1407-9..
Cimil B, Babu M. Maternal deaths in India: a review of trends and programmes. Int J Preven Curat Comm Med. 2021;7(3):17-21.
Yadav S, Tiwari D. To study the changes in the trends of maternal mortality before and after Janani Suraksha Yojana (JSY) in M.Y. Hospital, Indore during period (2000-2019). Ind J Obstet Gynaecol Res. 2020;7(4):559-62.
Doddamani U, Rampure N, Kaveri P. A study of maternal mortality in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):2446-8.
Lilare RR, Narlawar UW, Lillore R. Maternal Mortality in a Tertiary Care Hospital of Central India: A 5 years. JMSCR 2017;5(12):31820-24.
Bhatia M, Dwivedi LK, Banerjee K, Bansal A, Ranjan M, Dixit P. Pro-poor policies and improvements in maternal health outcomes in India. BMC Preg Childb. 2021;21(1):389.
Anjanadevi S, YelikarK, Deshpande S. Study of maternal mortality in a tertiary care center. Inter Med J. 2015;2(10):672-4.
Murthy BK, Murthy MB, Prabhu PM. Maternal mortality in a tertiary care hospital: a 10-year review. Int J Prev Med. 2013;4(1):105-9.
Ashok V, Santosh M, Anupa S. A study on maternal mortality. J Obstet Gynecol. 2008;58:226-9.
Suresh A, Nambiar M, Devasia JM. A study on maternal mortality in a tertiary care center in South India. Ind J Obstet Gynecol Res. 2019;6(2):173-6.
Gaikwad Nandkishor B, Poornima M, Reshma M. Lad. A retrospective study of maternal mortality in a tertiary care hospital in Western Maharashtra, India. Int J Res Med Sci. 2020;8(5):1796-1801.
Prajapati H, Parikh R. Analysis of maternal mortality: a retrospective study at tertiary care centre. Inter J Med Biomed Stud. 2021;5(4):118-20.
Sarmalkar MS, Nayak AH, Faisal S. A five-year retrospective study of maternal mortality in a tertiary referral centre. Int J Reprod Contracept Obstet Gynecol. 2021;10(5):1935-42.
Nukeshtayeva K, Kayupova G, Yerdessov N, Bolatova Z, Zhamantayev O, Turmukhambetova A. Maternal mortality determinants in a middle-income country: Retrospective study. Authorea. 2023.
Government of India. Office of The Registrar General India. Government of India. Special Bulletin on Maternal Mortality in India 2018-20: Sample Registration System. Available at: https://censusindia.gov.in/nada/index.php/catalog/44379. Accessed on 24 May 2023.
Sitaula S, Basnet T, Agrawal A, Manandhar T, Das D, Shrestha P. Prevalence and risk factors for maternal mortality at a tertiary care centre in Eastern Nepal-retrospective cross sectional study. BMC Preg Childb. 2021;21:1-8.
Fernandes JC, Swarup A, Nayak A, Shivananjaiah C, Gupta S. Maternal mortality at a tertiary care hospital: a retrospective study. JMSCR. 2015;3(10):7847-51.
Modi R. A retrospective study to evaluate epidemiological characteristics of maternal deaths in a tertiary level government hospital of Saurashtra region of Gujarat. Inter J Clin Obstet Gynaecol. 2020;4(4):124-7.
Hansda J, Roy D, Das K, Sarkar M, Das R, Pramanik A. Maternal mortality-a three-year retrospective study in a rural medical college of India. Int J Reprod Contracept Obstet Gynecol. 2021;10(8):3019-22.
MOHFW. Annual Report, 2019-20. Available at: https://main.mohfw.gov.in/sites/default/files/Annual%20Report%2020192020%20English.pdf. Accessed on 24 May 2023.
Ministry of Women and Child Development. Reduction in maternal mortality rate; 2020. Available at: https://pib.gov.in/PressReleaseIframe Page.aspx?PRID=1656242. Accessed on 24 May 2023.
MAA (Mothers’ Absolute Affection) programme for infant and young child feeding. Available at: https://www.nhp.gov.in/maa(mothers%E2%80%99-absolute-affection)-programmefor-infant-and-young-child-feeding_pg. Accessed on 24 May 2023.