scholarly journals Gambaran kematian maternal di RSUP Prof. Dr. R. D. Kandou Manado 1 Januari 2013 – 31 Desember 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Mustika S. Lumbanraja ◽  
Hermie M.M. Tendean ◽  
Maria Loho
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Age Group ◽  
Health Issues ◽  
Maternal Deaths ◽  
Working Mother ◽  
The Status ◽  
Using Data ◽  
And Child Health

Abstract: Maternal death is the death of a pregnant woman or death within 42 days after the termination of pregnancy, irrespective of the length and location of the pregnancy, caused by anything related to pregnancy, or aggravated by the pregnancy or its handling, but not the death caused by accident or accidentally. Maternal mortality is one of the indicators to evaluate the progress of the health of a country, especially those related to maternal and child health issues. This study was aimed to determine the characteristics of maternal death. This was a descriptive retrospective study using data of the Medical Record Department of Prof. Dr. R. D. Kandou Manado from 1 January 2013 to 31 December 2015. In this study, there were 41 cases of maternal deaths. In 2013 and 2014, the highest death rate was in the age group >35 years, while in 2015 in the age group 20-25 years. Based on the number of parity, the highest mortality rates in the number of parity 2-3 in 2013 and 2014, while in 2015 the number of parity ≤1. The highest mortality rate by level of education was high school educated. Based on employment status, the highest mortality rate was in the group of working mother. The highest death toll was based on marital status in the group who are married. Based on the status of the referral highest mortality rate was in status is not a referral. This study found that the highest cause of maternal mortality is three consecutive years eclampsia, sepsis, eclampsia. Conclusion: Of 41 cases of maternal deaths in the Department of Prof. Dr. R. D. Kandou Manado for 3 years, the most cause of death was due to eclampsia/pre-eclampsia which was 4-7 cases each year. Maternal mortality rate per 100000 live births yearly in sequence were 373, 427, 789.Keywords: maternal death Abstrak: Kematian maternal adalah kematian wanita yang terjadi saat hamil atau dalam 42 hari setelah berakhirnya kehamilan, tidak tergantung dari lama dan lokasi kehamilan, disebabkan oleh apapun yang berhubungan dengan kehamilan, atau yang diperberat oleh kehamilan tersebut atau penanganannya, tetapi bukan kematian yang disebabkan oleh kecelakaan atau kebetulan. Kematian maternal merupakan salah satu indikator untuk melihat kemajuan kesehatan suatu negara, khususnya yang berkaitan dengan masalah kesehatan ibu dan anak. Penelitian ini bertujuan untuk mengetahui gambaran kematian maternal. Jenis penelitian ini ialah deskriptif retrospektif menggunakan rekam medik di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2013-31 Desember 2015. Pada penelitian ini, ditemukan 42 kasus kematian maternal. Pada tahun 2013 dan 2014 angka kematian tertinggi di kelompok usia >35 tahun, sedangkan tahun 2015 ditemukan di kelompok usia 20-25 tahun. Berdasarkan jumlah paritas, angka kematian tertinggi pada jumlah paritas 2-3 di tahun 2013 dan 2014, sedangkan untuk tahun 2015 pada jumlah paritas ≤1. Angka kematian tertinggi berdasarkan tingkat pendidikan ialah SMA. Berdasarkan status pekerjaan, angka kematian tertinggi berada pada kelompok ibu yang bekerja. Angka kematian tertinggi berdasarkan status pernikahan berada pada kelompok yang sudah menikah. Berdasarkan status rujukan angka kematian yang tertinggi ialah pada status bukan rujukan. Pada penelitian ini ditemukan penyebab kematian ibu yang tertinggi 3 tahun berurutan ialah pre-eklampsia/eklampsia, infeksi, pre-eklampsia/eklampsia. Simpulan: Jumlah kematian maternal di RSUP Prof. Dr. R. D. Kandou Manado selama 3 tahun yaitu sebanyak 41 kasus. Penyebab kematian terbanyak disebabkan oleh eklampsia/pre-eklampsia yaitu 4-7 kasus per tahun. Angka kematian ibu per 100000 kelahiran hidup per tahun berurutan ialah 373, 427, 789. Kata kunci: kematian maternal

scholarly journals GAMBARAN ANGKA KEMATIAN IBU DI RSUP. Prof. Dr. R. D. KANDOU MANADO PERIODE JANUARI 2014 – SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Ria Mariani Andini ◽  
Joice Sondakh ◽  
Bismarch J. Laihad
Keyword(s):  
Maternal Mortality ◽  
Hemorrhagic Stroke ◽  
Maternal Mortality Ratio ◽  
Sampling Technique ◽  
Complex Problem ◽  
Health Issues ◽  
Maternal Deaths ◽  
Live Births ◽  
Mortality Ratio ◽  
And Child Health

Abstract: Maternal mortality is a complex problem that is caused by a variety of causes that can be distinguished on the determinant of near, intermediate and far. Maternal mortality or maternal death is one indicator to see the progress of the health of a country, especially with regard to maternal and child health issues. The research objective was to determine the description of Maternal Mortality Rate (MMR) in RSUP Prof. Dr. dr. R. D. Kandou Manado period January 2014 - September 2015. Methods: This study is a retrospective descriptive study. The population is all deliveries in RSUP Prof. Dr. dr. R. D. Kandou Manado period January 2014 - September 2015. The samples is 20 persons, sampling with total sampling technique. Results: based on this research, the highest number of births was in 2014 that as many as 3,347 people (70.8%), while in 2015 as many as 1,380 people (29.2%). Maternal Mortality Ratio (MMR) was 298 per 100,000 live births in 2014 and 725 per 100,000 live births in 2015. The number of maternal deaths in the period from January 2014 through September 2015 respectively by 10 people (50%). The most diagnosis entry patients is eclampsia by 10 persons (50.0%) Based on the causes of maternal mortality, that most because of hemorrhagic stroke by 7 people (35.0%).. Conclusion: Maternal Mortality Ratio (MMR) was 298 per 100,000 live births in 2014 and 725 per 100,000 live births in 2015. By entering the patient's diagnosis, most of the patients with the diagnosis of eclampsia and cause most maternal deaths are patients who died because stroke hemorrhagic period January 2014 through September 2015.Keyword: Maternal Mortality RateAbstrak: Kematian ibu merupakan salah satu indikator untuk melihat kemajuan kesehatan suatu negara, khususnya yang berkaitan dengan masalah kesehatan ibu dan anak. Tujuan penelitian adalah mengetahui gambaran Angka Kematian Ibu (AKI) di RSUP. Prof. Dr. R. D. Kandou Manado Periode Januari 2014 – September 2015. Metode: penelitian ini merupakan jenis penelitian deskriptif retrospektif. Populasi yang diambil adalah semua persalinan di RSUP. Prof. Dr. R. D. Kandou Manado Periode Januari 2014 – September 2015. Jumlah sampel adalah 20 orang, penentuan sampel dengan teknik total sampling. Hasil: berdasarkan hasil penelitian, jumlah persalinan terbanyak adalah pada tahun 2014 yaitu sebanyak 3.347 orang (70,8%) sedangkan pada tahun 2015 sebanyak 1.380 orang (29,2%). Rasio Angka Kematian Ibu (AKI) 298 per 100.000 kelahiran hidup pada tahun 2014 dan 725 per 100.000 kelahiran hidup pada tahun 2015.Sedangkan jumlah Jumlah Kematian Ibu pada periode januari 2014 sampai september 2015 masing-masing sebanyak 10 orang (50%). Diagnosa masuk pasien terbanyak yaitu eklamsia sebesar 10 orang (50,0%) Berdasarkan penyebab kematian ibu, yang tebanyak karena stroke hemoragik sebesar 7 orang (35,0%). Kesimpulan: Rasio Angka Kematian Ibu (AKI) adalah 298 per 100.000 kelahiran hidup pada tahun 2014 dan 725 per 100.000 kelahiran hidup pada tahun 2015. Berdasarkan diagnosis masuk pasien, terbanyak adalah pasien dengan diagnosa eklampsia dan penyebab kematian ibu terbanyak adalah pasien yang meninggal karena stroke hemoragik periode januari 2014 sampai september 2015.Kata kunci: Angka Kematian Ibu

scholarly journals Maternal mortality at a tertiary care teaching hospital in Dibrugarh district, Assam: a retrospective study

2017 ◽  
Vol 4 (9) ◽  
pp. 3342
Author(s):  
Lima Hazarika ◽  
Pranay Phukan ◽  
Anand Sharma ◽  
Nabajit Kr. Das
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Teaching Hospital ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Deaths ◽  
Tertiary Care Teaching Hospital ◽  
Live Births ◽  
Care Teaching

Background: Maternal mortality is a measure of quality of health care in a community. Assam has the highest maternal mortality rate among all India’s states, which is almost double the national average, with around 328 deaths per 100 000 live births. Three quarters of these deaths are among the tea plantations community. It has serious implications on the family, the society and the nation. Maternal mortality rate (MMR) is a very sensitive index that reflects the quality of reproductive care provided to the pregnant women. The objective of the study was to assess the Institutional maternal mortality and the causes of maternal death over a period of a year at a Tertiary Care Teaching Hospital in Dibrugarh district, Assam.Methods: A retrospective hospital based study of maternal death cases from September 2015 to August 2016 was conducted to assess the maternal mortality. The study was carried out in the Obstetrics and Gynaecology Department of Assam Medical College and Hospital (AMCH), Assam. The study included 48 maternal deaths in the year. The information regarding reproductive parameters was collected from the maternal death register and the results were analyzed by using percentage.Results: Out of 9789 total deliveries, Institutional Maternal Mortality was found to be 490 per 1, 00,000 live births. The maternal death was high among the Tea Garden community (66.7%) at the age group 15–20 years and was prevalent mainly in the illiterates (31.3%). Anaemia (29.1%) was the leading cause of death; followed eclampsia (23.0%) and septicaemia (17.0%) while cardio respiratory failure was indirect leading cause for maternal deaths.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths were preventable. Most maternal deaths can be limited by utilisation of existing medical facilities and identifying the barriers in accessing health delivery system. Early identification of high risk pregnancies and regular ante-natal check up with timely referral to tertiary care centre can help reduce the mortality among the women. 

scholarly journals Maternal mortality: A 10-year study at Nishtar Hospital Multan

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Huma Quddusi ◽  
Sajjad Masood ◽  
Sobia Mazhar ◽  
Samee Akhtar
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Causes Of Death ◽  
Age Group ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Causative Factors ◽  
Management Of Complications ◽  
Age Range

Objective: To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. Design: An analytical, hospital-based study. Place and duration of study: Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. Patients and methods: During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate (MMR), causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. Results: A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB (live births). 7(3.9%) patients were below the age of 20, 74(41.5%) were in the age group of 21-30 and 82(46%) in 31-40 years age range. 15(8.42%) were above the age of 40. Most of them (69%) were grand multiparas (Parity >5). The major causative factors were haemorrhage 63(35.4%), eclampsia 41(23.03%), sepsis 25(14.04%), anaemia 18(10.1%), hepatic encephalopathy 14(7.9%), abortion 11(6.2%). Majority of the patients were unbooked and presented in the hospital very late. Conclusion: A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup.

scholarly journals Maternal Death Related to Sudden Unexpected Death in Epilepsy: A Nationwide Survey in Japan

2021 ◽  
Vol 11 (8) ◽  
pp. 995
Author(s):  
Hiroaki Tanaka ◽  
Shinji Katsuragi ◽  
Junichi Hasegawa ◽  
Kayo Tanaka ◽  
Masamitsu Nakamura ◽  
...  
Keyword(s):  
Risk Factor ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Nationwide Survey ◽  
Sudden Unexpected Death ◽  
Mortality Data ◽  
Third Trimester ◽  
Unexpected Death ◽  
Maternal Deaths ◽  
Using Data

Sudden unexpected death in epilepsy (SUDEP) is defined as the sudden death of a patient with epilepsy in the absence of an anatomic or toxicologic cause. Whether pregnancy is a risk factor for SUDEP is unclear. Using data submitted to the Japan Association of Obstetricians and Gynecologists (JAOG), which has been collating information regarding all maternal deaths in Japan since 2000, this study evaluated maternal mortality data from 2010 to 2019 to evaluate the current circumstances of maternal death related to SUDEP in Japan. Six women died due to SUDEP during this period; the maternal mortality rate related to SUDEP was 0.066/100,000 individuals. Two women each died during the second trimester, third trimester, and postpartum period. Four and two women were receiving monotherapy and no therapy with anti-epileptic drugs, respectively. The duration of epilepsy was ≤15 years in three women, >15 years in one woman, and unknown in two women. This study furthers our understanding of the prevalence of maternal deaths due to SUDEP in Japan. Further studies are needed to confirm whether pregnancy is a risk factor for SUDEP.

scholarly journals Statistical analysis of the maternal death rate at the Ebonyi State University Teaching Hospital, Abakaliki, for the year ending 31 December 2007

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Uchechukwu M. Okeh
Keyword(s):  
High Risk ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Teaching Hospital ◽  
Maternal Death ◽  
Death Rate ◽  
University Teaching ◽  
State University ◽  
Maternal Deaths ◽  
Mortality Ratio

Background: The maternal mortality rate in developing countries, such as Nigeria, remains relatively high, with the causes being multidimensional. The unbooked primigravidae with severe pre-eclampsia/eclampsia constitute a high risk group.Method: The data from the case notes of all the maternal deaths that occurred at the Ebonyi State University Teaching Hospital, Abakaliki, between 1 January and 31 December 2007 form the basis of this study. The case notes relating to all such deaths were stored in the office of the Head of the Department of Obstetrics and Gynaecology when the deaths occurred. Information was extracted from the case files at the end of 2007. Data relating to the total number of deliveries were obtained from the registers kept in the labour and isolation wards.Results: Of the 45 maternal deaths recorded, 40 (88.9%) were found to have occurred among the unbooked and 5 (11%) among the booked mothers, constituting a maternal mortality ratio (MMR) of 23 121.4 and 339.7 per 100 000 deliveries respectively. The combined mortality ratio was 2 735.6 per 100 000 deliveries. Fifteen (37.5%) unbooked primigravidae were found to have died of severe pre-eclampsia/eclampsia. A total of 1 645 mothers were noted to have delivered babies, of whom 1 472(89.5%) were booked, and 173 (10.5%) unbooked, with the hospital.Conclusion: Severe pre-eclampsia/eclampsia, haemorrhaging and sepsis were the major causes of death. A high maternal mortality rate was found to be common among the unbooked primigravidae, who are known usually to present late with pre-eclampsia/eclampsia. More research into the causes and management of pre-eclampsia/eclampsia is needed to reduce the high maternal death rate associated with it. The lack of antenatal care is also a high risk factor for maternal death.

scholarly journals Causes of Maternal Mortality: Our Scenario

2013 ◽  
Vol 5 (3) ◽  
pp. 96-98
Author(s):  
Monica Soni ◽  
Prasoon Soni ◽  
Sudesh Agrawal ◽  
Haritasha Mehra
Keyword(s):  
Maternal Mortality ◽  
South Asian ◽  
Child Health Services ◽  
Retrospective Evaluation ◽  
Obstetric Hemorrhage ◽  
Contributing Factors ◽  
Maternal Deaths ◽  
Systemic Analysis ◽  
The Status ◽  
And Child Health

ABSTRACT Objective To analyze the cases of maternal mortality over a period of 3 years with regard to direct, indirect and associated causes and social correlates. Materials and methods Retrospective evaluation of the cases with respect to causes, admission to mortality interval, age, parity, antenatal booking, socioeconomic status, etc. and systemic analysis of all contributing factors. Result and observation A total of 66.67% of the deaths were due to direct causes with obstetric hemorrhage being the most common cause followed by puerperal sepsis. Anemia was the most important indirect cause followed by hepatitis and cardiovascular diseases. Conclusion A large number of maternal deaths seem to be avoidable if we are able to strengthen our maternity and child health services. Equally important, however, remains the upgradation of the status of females in the society with emphasis on literacy and general health awareness. How to cite this article Soni M, Agrawal S, Soni P, Mehra H. Causes of Maternal Mortality: Our Scenario. J South Asian Feder Obst Gynae 2013;5(3):96-98.

scholarly journals The assessment of maternal deaths between 2015 and 2020 in Elazığ, Turkey

2020 ◽  
Vol 28 (3) ◽  
pp. 183-189
Author(s):  
İbrahim Batmaz ◽  
Salih Burçin Kavak ◽  
Ebru Çelik Kavak ◽  
Evrim Gül ◽  
Cengiz Şanlı ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Public Health Issue ◽  
Family Practitioner ◽  
Delay Model ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Death Cases

Objective: To determine the maternal deaths and the factors affecting them in our city. Methods: The maternal deaths occurred in our city between January 2015 and June 2020 were reviewed retrospectively. The review was conducted by checking “Maternal Death Registry Forms” of the Provincial Directorate of Health. In cases where additional data related with the cause of death were required, the relatives of the cases, associated family practitioner, The Council of Forensic Medicine or local authorities were contacted. The data of the cases including age, gravida, parity, abortion, delivery type, week of gestation during delivery, period of death and maternal deaths due to direct, indirect and incidental causes were recorded. Based on total live births and maternal deaths within 6.5 years, maternal mortality rate was found as the maternal death number per 100,000 live births. Descriptive statistics were used for the statistical analysis of the data. Results: A total of 46.618 live births occurred between 2015 and 2020 in Elazığ. The number of maternal deaths due to direct and indirect causes is 7, and maternal mortality rate was found 15.01/100,000. Hypertensive diseases during pregnancy (n=3, 42.8%), pulmonary embolism (n=1, 14.3%) and cerebral thrombosis (n=1, 14.3%) were among the natural causes of maternal deaths. Indirect cause for maternal death was cardiac diseases (n=2, 28.6%). When they were categorized according to the Three Delays Model, there were 3 death cases in the first delay model and 2 death cases in the third delay model, but there was no maternal death in the second delay model. Conclusion: Maternal death is an significant public health issue which develops due to the generally preventable causes and maintains its importance. The factors contributing to death should be paid attention in order to decrease maternal death rates.

scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.

scholarly journals Maternal mortality-a three-year retrospective study in a rural medical college of India

2021 ◽  
Vol 10 (8) ◽  
pp. 3019
Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Demographic Profiles ◽  
Medical College ◽  
Mortality Ratio ◽  
Tragic Event

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.

scholarly journals MATERNAL MORTALITY

2009 ◽  
Vol 16 (01) ◽  
pp. 135-138
Author(s):  
TASNIM TAHIRA REHMAN ◽  
MAHNAZ ROOHI
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Level ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Study Setting ◽  
Very High

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.

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