Maternal death audit at tertiary care centre: changing trends

Background: The aim of the study was to analyse the trend in maternal mortality ratio in a tertiary care centre.Methods: This was a four-year retrospective analysis of maternal deaths that occurred at Government Rajaji Hospital, Department of Obstetrics and Gynaecology, Madurai from January 2017 to December 2020. Cases were stratified based on cause of death. Epidemiological data was collected from the hospital register.Results: The total number of maternal deaths at GRH during the study period is 228, in which death due to obstetric cause was 82 (36%) and non-obstetric cause was 146 (64%). The most common cause in each year was PIH (23%-2017, 29%- 2018), heart disease (22%- 2019) and infection (46%- 2020).Conclusions: We concluded by this study that the maternal death due to non-obstetric causes were more than the obstetric causes due to improved antenatal, post-natal care, institutionalized deliveries and timely referral to the CEmONC (comprehensive emergency obstetric and new-born care) centres and management.

Maternal Death Audit: Experience from a Periurban Hospital

Maternal death audit is becoming a routine process in the practice of obstetric care in both developed and developing countries. Review of case records of maternal deaths between September 1999 and December 2004 was done to find out the profile of the patients and factors associated with the deaths in a periurban hospital in Dhaka. A total 40 maternal deaths occured among 14,137 live births amounting MMR 282 per 100,000 live births. Mean age of deceased mothers was 24.85± 5.6 years, 25% were primipara and vaginal delivery occurred in 42.46% cases. Thirty percent deaths occured within six hours of admission to hospital and 73% deaths occurred during post-partum period. The primary obstetric cause of deaths were severe pre-eclampsia and eclampsia (42.5%), haemorrhage (17.5%), obstructed labour (12.5%) and sepsis (7.5%) respectively. Facility based audit into maternal deaths provide an opportunity to understand the inciting factors and is recommended to be implemented for improvement of professional practice and management. (J Bangladesh Coll Phys Surg 2006; 24: 5-9)