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Review of Maternal Mortality at a Tertiary Care Hospital: What Have we Achieved?

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The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background

Mothers are the nurturing pillar of the family. When a woman dies or becomes ill, either during or after giving birth, the consequences have the potential to affect not only the woman herself, but her family, society and the nation as well.

Objectives

The study was designed to evaluate the maternal mortality ratio in a tertiary care hospital, assess the demographic profile, causes of maternal mortality, type of delay, and to suggest remedial measures for improvement.

Methods

A retrospective study was done from Jan 2013 to Dec 2016 at a tertiary care hospital in New Delhi. The medical records of all maternal deaths over a period of 4 years were reviewed and analyzed.

Results

The Maternal mortality ratio in the study period was 361.71/100,000 live births. The number of maternal death was 364. Unbooked cases accounted for the majority, i.e., 322, booked being 29 and registered 13. Two hundred and eleven cases were referred from other centers. Maximum deaths occurred between 21 and 30 years (73.07%). Anemia was widely prevalent. Most maternal deaths were due to direct causes like hypertensive disorders (28.02%), pregnancy-related infections (20.87%), and hemorrhage (12.36%). Among indirect causes, anemia, hepatitis, heart disease and respiratory illness accounted for 15.93, 11.53, 3.29 and 5.49%, respectively. Type I delay was most common (64.28%).

Conclusion

Strengthening of the peripheral centers, hiring competent staffs and adequate blood bank facilities together with reference linkages must be done. Auditing the causes for maternal mortality is extremely helpful to identify the preventable causes and delays.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, VMMC & Safdarjung Hospital, New Delhi, India

    Pratima Mittal, Garima Kapoor, Nikita Kumari & Bindu Bajaj

  2. Sitaram Bhartia Institute of Science and Research, New Delhi, India

    Nikita Kumari

  3. New Delhi, India

    Nikita Kumari

Authors
  1. Pratima Mittal
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  2. Garima Kapoor
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  3. Nikita Kumari
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  4. Bindu Bajaj
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Corresponding author

Correspondence to Nikita Kumari.

Ethics declarations

Conflict of interest

Pratima Mittal, Garima Kapoor, Nikita Kumari, Bindu Bajaj declare that they have no conflict of interest.

Human Participants

The data were gathered from the individual case sheets and facility-based maternal death review forms. These forms were filled by the treating doctor and reviewed by the supervising Faculty within 24 h of the death of the women. Hence, the institutional review body explicitly approved the study.

Informed Consent

No consent taken as there was no intervention with the patient for the purpose of study. Only the data were gathered from individual case sheets and facility-based maternal death review forms.

Additional information

Pratima Mittal is a Professor and Head of Department, Department of Obstetrics and Gynecology, VMMC & Safdarjung Hospital, New Delhi; Garima Kapoor is an associate professor, Department of Obstetrics and Gynecology, VMMC & Safdarjung Hospital, New Delhi; Nikita Kumari is a Junior Consultant at Sitaram Bhartia Institute of Science and Research and Ex-Senior Resident, Department of Obstetrics and Gynecology, VMMC & Safdarjung Hospital, New Delhi; Bindu Bajaj is a Senior Specialist and Associate Professor, Department of Obstetrics and Gynecology, VMMC & Safdarjung Hospital, New Delhi.

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Mittal, P., Kapoor, G., Kumari, N. et al. Review of Maternal Mortality at a Tertiary Care Hospital: What Have we Achieved?. J Obstet Gynecol India 69, 149–154 (2019). https://doi.org/10.1007/s13224-018-1129-1

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  • DOI: https://doi.org/10.1007/s13224-018-1129-1

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