An Audit of Maternal Mortality at a Tertiary Care Hospital

Abstract

Objective: To find causes of maternal deaths and to calculate maternal mortality ratio at tertiary care hospital Karachi. Study Design and setting: An observational study was conducted from1st January 2019 to 31st December 2020 at the Department of Obstetrics & Gynecology Unit 1, JPMC Karachi. Methodology: Patients were selected according to inclusion criteria after ethical approval through non probability consecutive sampling technique. Details of patients were obtained from files and record registers. Their demographic feature like age, parity, gestational age, booking status and presence or absence of medical disorders, their status of delivery and direct and indirect reasons of maternal deaths were noted and their frequency and percentages were calculated. Brought dead patients and those who died accidently were excluded from the study. Results: During the period of two years the total numbers of deaths certified in the department were 90. Total number of child birth and live births were 19084 and 17892 respectively. The maternal mortality ratio was estimated as 503.01 per 100,000 live births. Most of the patients 74(82.3%) were un booked. Direct Causes were about 67(74.5%). Haemorrhage was found to be most common reason of maternal deaths in about 21(23.3%). Eclampsia among18(20%) deaths. Anemia, cardiac disease, hepatic failure were the indirect causes of maternal deaths responsible for 23 (25.5%) of maternal deaths. Conclusion: Maternal Death rate is persistently elevated in JPMC, being tertiary care hospital mostly due to serious and referred complicated cases. Haemorrhage and eclampsia are still major killers of mothers as before.