Analysis of Maternal Morbidity and Mortality Referred to Tertiary Care Hospitals of Pakistan
Syeda Khalida Naeem, Nidda Yaseen, Anisa Saleem, Afshan Shahid, Saira Iqbal
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ABSTRACT
Background and Aim: Maternal morbidity is a major health problem affecting approximately millions of women
annually and had a substantial influence on fetal and infant health that might lead to maternal mortality. Maternal
mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health
care services available. The present study was conducted in order to analyze the maternal morbidity and mortality
cases referred to a tertiary care hospital.
Methodology: This cross-sectional study was conducted on 89 maternal deaths out of 9874 obstetrical
admissions or births referred to department of Gynae/Obs of tertiary care hospitals i.e Makran Medical College,
Turbat/ Teaching Hospital, Kech and Darul Sehat Hospital, Karachi over a period of five years from 2017 to 2021.
All the pregnant women with gestation age >24 weeks admitted for any obstetrical emergencies were enrolled in
this study. Patient’s demographic characteristics, clinical features during admission, and maternal relevant
information were collected on pre-designed proforma. SPSS version 21 was used for data analysis.
Results: Out of total 9874 births, maternal deaths were 89; the mortality incidence with prevalence was
hemorrhage 7 (7.9%), hypertensive disorders 34 (38.2%), anesthetic issue 2 (2.2%), sepsis 14 (15.7%), and
medical complications 31 (34.8%). The occurrence of direct and indirect maternal death was 55 (61.8%) and 34
(38.2%) respectively. The incidence of the mortality rate was 22.9%. Of the total 387 morbidity cases,
hypertensive disorders were the prevalent cause with 295 (76.2%) cases followed by obstetric hemorrhage 55
(14.2%), medical complications 25 (6.5%), sepsis 11 (2.8%), and anesthetic complications 1 (0.3%). The
incidence of morbidity was 77.4 per year.
Conclusion: Medical complications, sepsis, and hemorrhage are the leading causes of maternal mortality,
followed by hypertensive disorders. Mortality and morbidity rates were 22.9% and 3.9% respectively. All of these
causes can be avoided with proper antenatal care facilitation.
Keywords: Hemorrhage, Maternal mortality, Sepsis