Why Do Mothers Die?

Objective: To identify the main causes and associated risk factors contributing to maternal deaths. Study Design: Analysis of retrospective data. Place and Duration of Study: Department of Obstetrics and Gynecology, Fatima Memorial Hospital from January 2001 to December 2005. Method: The medical records of the women dying were reviewed. Demographic record including age, parity, socioeconomic status and antenatal care were analyzed from patient’s records. Results: Seventeen maternal deaths were recorded during the study period with the maternal mortality ratio MMR of 58.53/100,000 live births (17/29042). The causes of death in all 17 cases were made on clinical assessment done jointly by Gynaecologist, Anaesthetist and Physician as post-mortem examination was not done. The major causative factor for maternal death was hypertensive disorder 6 (35.29%) followed by coagulation disorder due to intrauterine death 2 (11.76%), amniotic fluid embolism 2 (11.76%) and fatty liver of pregnancy 2 (11.76%). Causes like thromboembolism, haemorrhage, anaesthetic complications and puerperal myocarditis were responsible for a single death each. No cause could be ascertained in one case. The age of the women who died ranged between 21-39 years. There were 7 primigravidas (41.17%), 7 (41.17%) were Para 1-4 (41.17%) and 3(17.64) women had parity more than 4. Most of them had poor socioeconomic status. Only 4 women were booked (23.52%). The rest 13 women (76.47%) were unbooked. Conclusion: Most of the causes of maternal deaths are preventable if timely identified and treated by skilled health care professionals.