A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat

Maternal mortality is still a big health concern in developing world. The state of maternal health represents overall state of women’s right in health, social and economic realms. If the causes of death can be addressed and are found to be preventable it indicates negligence on the part of government and the entities that have the power to implement the changes. To determine factors and causes of maternal mortality this retrospective observational study was conducted in the department of obstetrics and gynaecology, BJ medical college. Maternal mortalities from October 2016 to March 2018 (18 months) were analysed with respect to factors like locality, literacy, parity, ANC care, time after admission, type of delay (according to maternal death review form) and causes of death (direct and indirect causes of MMR). Total 92 maternal deaths were studied and that gave a MMR of 468 per 1,00,000 live births. Maximum deaths occurred in patients who were in the age group of 20-34 (83.1%), rural locality (71%), Irregular with ANC visits (74%), multigravida (56.5%), within 24 hours of delivery (46.7%) and those who had type 1 delay (delay in decision making to seek help, 78.3%). More of deaths occurred in post partum (84.8%) and in vaginal mode of delivery (47.4) Vs Caesarean section (46.3). Direct obstetric causes of death (57.6%) were of deaths which included hypertensive disorders (29.3%), haemorrhage (19%) and others. Indirect causes accounted for 42.4% deaths which included hepatitis (21.7%), heart diseases (9.8%) etc. Early intervention and diagnosis with timely management are essential to reduce morbidity and hence maternal mortality. Special attention should be given to Routine Antenatal care (RANC) and more specifically to Focussed Antenatal Care (FANC)). Lack of expertise at primary level with lack of proper referral system adds to the cause.