Maternal Mortality Ratio and its Causes at Nishtar Hospital Multan

Abstract

Objective: To determine the maternal mortality ratio and its causes at Nishtar Hospital Multan.

Study Design: Prospective observational study

Place and Duration of Study: This study was conducted at the Department of obstetrics & Gynaecology at Nishtar Hospital Multan over a period of 3yrs from January 2015 to October 2017.

Materials and Methods: It included all the mortalities in labour ward due to direct and indirect causes during pregnancy, labour and puerperium. The descriptive statistics were used for age, parity, cause of death and possible factors responsible for death were identified.

Results: There were total of 34394 deliveries and 34050 live births. Total 339 maternal deaths occurred during 3years period from January, 2015 to 31, October 2017 with MMR 995.6/100,000 live birth. The highest maternal mortality age group was less than 30yrs. Majority of the patients were between P₂-P₄.  Obstetrical hemorrhage was the most frequent cause (41.29%) followed by hypertensive disorders (30.9%), blood transfusion reactions (10.3%), septicemia (8.8%), thromboemobolic  events (5.8%), ruptured uterus (5.3%), operative complications leading to internal haemorrhage (3.5%) &cardiac disease (1.7%), less frequent causes were ectopic pregnancy (1.1%) and hepatic failure (0.8%).

Conclusion: Most of these deaths are preventable. Sustained reduction in maternal mortality will only be possible if modern obstetrics care is made available through a system of professional qualified midwifery and referral system along with political commitment and accountability of health providers. Concentrated efforts are required to obtain missing data, accurate data collection, health education awareness and transport facilities to prevent many deaths.