BACKGROUND: Maternal death has been recognized as an area of maternal care that requires urgent attention.Making efforts to decrease maternal mortality is a matter of great concern to the obstetricians. MMR is a very sensitive index that reflects quality of reproductive care provided to the pregnant woman.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: It was a retrospective study.The medical records of all maternal deaths occurring over a period of 4 years between January 2010and December 2013 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%, hepatitis13.84%, 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.

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