Objectives: The aims of the study were to help generate information and knowledge regarding the causes and complications leading to maternal deaths (MDs) in an urban tertiary care hospital, to find if any of them are potentially preventable, and to use information thus generated to save lives. Methods: The medical records of all MDs occurring over a period of 4 years between January 2003 and December 2006 were reviewed and correlated with maternal age, antenatal registration, mode of delivery, parity, admission death interval, and causes of death. Results: The maternal mortality rate (MMR) ranged between 926 and 377/100,000 births in the study period. The causes of deaths were sepsis 23.84%, eclampsia /pregnancy-induced hypertension 17.69%, hemorrhage 13.84%, hepatitis 13.84%, anemia 13.07%, respiratory infections 8.46%, other indirect obstetrical causes 6.15%, and unrelated causes 4.61%. Maximum deaths (71.53%) occurred in women between 21 and 30 years of age while multigravida had MMR of 51.53%. Mortality was highest in postnatal mothers 63.06%.Unbooked cases constituted 92.31% of MDs and included 25% referred cases. Conclusion: Overall maternal mortality was 690/100,000. MDs due to direct obstetric causes were 55.38%, indirect obstetric deaths 40%, and unrelated deaths 4.61%. The causes of potentially preventable deaths include deaths due to anemia, sepsis, hemorrhage, DIC, and anesthesia complication, and accounted for 25.38% of all deaths.

IntroductionLichen planus is an immune mediated inflammatory lesion involving skin and mucosal sites including oral mucosa, vulva and rarely vagina. Lichen planus occurring at mucosal sites has been shown to be associated with squamous cell carcinoma in a proportion of cases. To the best of our knowledge, no case of lichen planus of uterine cervix has been reported in the available literature.Case PresentationA 45-year-old female underwent vaginal hysterectomy for uterine prolapse. The resected specimen showed a bluish-colored area in the non-dependent part of the ectocervix. Microscopic sections from this area showed dense lymphocytic infiltrate at the junction of mucosa and submucosa causing disruption of the basal cell layer. On immunohistochemical examination there was predominance of CD8+ T lymphocytes at the junction with scattered CD4+ T lymphocytes, characteristic of lichen planus. Based on the history and negative serum antibody titers, other differential diagnoses including lupus erythematosus and drug reaction were excluded. The patient did not have any cutaneous or oral lesions of lichen planus.ConclusionLichen planus of uterine cervix is a hitherto unreported entity, and is worth studying considering the premalignant potential of lichen planus at other mucosal sites.