Objective: Evaluation of the frequency of anticardiolipin antibodies and lupus anticoagulant levels in women with histories of three or more first trimester recurrent miscarriages. Methodology: It was a descriptive case series carried out at private clinical practice in Peshawar. About 86 patients were enrolled in the study. They had three or more first trimester recurrent abortions. Pregnant patients between ages 22 and 35 years were included. Any patient diagnosed with other etiologies of recurrent miscarriages was excluded. Percentages  and frequencies were used to analyze the data. Results: Mean age of pregnant patients was 28.4(±3.25) years. Mean number of miscarriages was 3.5. High anticardiolipin antibodies were detected in 23.3% of pregnant patients. There was no pronounced difference regarding high levels of IgG and IgM. No case of raised lupus anticoagulant was found. Conclusion: Pregnant patients who experience recurrent miscarriages show higher prevalence of antibodies of anticardiolipin type. It is recommended that all such cases should be subjected to APS screening.

Objective: To describe the trends in maternal mortality in tertiary care hospitals in the last five years and compare the mortalities in the previous ten years. Methods: All pregnant women from January 2016 to December 2020 were analyzed. The primary outcome of this research was maternal mortality ratios. Various causes of maternal mortality were also evaluated. The correlation between maternal characteristics and maternal mortality was inspected using logistic regression models. Pregnancy outcomes of mothers who died versus mothers who survived were also evaluated. Results: One hundred seventy-three maternal deaths were noted in 49283 pregnant women in 2016-2020. The average maternal mortality ratio in 5 years period was 409 per 100,000 live births. It showed a decreasing curve over the five years, from 539/100,000 live births in 2016 to 295 in 2020. Five year clusters also demonstrated a falling trend, from 856/100,000 live births to 409. Hemorrhage (34.68%), hypertensive disorders of pregnancy (21.38%), suspected cases of thromboembolism (20.80%) were the leading causes of maternal mortality. Pregnancy outcomes in mothers who survived and who expired were evaluated. Almost 33% of maternal deaths had stillbirths as compared to 4.69% in alive mothers (RR 6.87); similarly, unknown outcomes (RR7.56) and ectopic pregnancies (RR 3.01) were more frequent in cases of maternal demise. Conclusion: Trends in maternal mortality show a decreasing curve. Hemorrhage remains the leading cause. Attainment of SDGs requires interventions both at primary and tertiary health care. Keywords: Maternal mortality and Maternal Mortality Ratio (MMR), trends, causes of maternal mortality.