A RETROSPECTIVE AND PROSPECTIVE STUDY OF MATERNAL MORTALITY IN A RURAL TERTIARY CARE HOSPITAL OF CENTRAL INDIA

Objectives: The aim of present study was maternal death audit in rural tertiary care centre, GMH Rewa, to find out avoidable/unavoidable factors in each death and use information thus generated to reduce maternal mortality. Methods: Medical records of all maternal deaths occurring over a period of 4 years between Jan 2006 to Oct. 2009 were reviewed and from Nov. 2009 to Dec. 2010 all maternal deaths were followed and studied in details in respect to maternal age, parity, booking status, delivery status, residence, referral, socioeconomic class, admission death interval and cause of death. Results: Maternal mortality ratio ranged between 426 to 641/1,00,000 births in the study period. The causes of death were haemorrhage (31.9%), toxaemia (24.4%), anemia (14.94%), sepsis (9.27%), embolism (7.2%), jaundice (5.72%) and other indirect causes (6.15%). Maximum of deaths (77.6%) occurred in women between 20-29 years of age, multigravida had Maternal mortality ratio of 56.71%. 72.16% cases were postnatal cases, 94.32% were unbooked, 50.0% were referred cases & 88.65% cases were from rural areas. Conclusion: Overall maternal mortality was 555.5/1,00,000 live births. Maternal deaths due to direct obstetric causes were 73.19% and indirect obstetrics deaths 26.81%. The causes of potentially preventable deaths includes death due to anemia, sepsis, Disseminated Intravascular Coagulation, anaesthesia complications and non-availability of ICU bed and accounted for 40% of all deaths