Maternal deaths

Abstract

Background: Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy. This can be due to direct causes or indirect unrelated causes. It is an important indicator of health-care services. Autopsy, which is an important tool of investigation, provides valuable input regarding the sequence of events leading to maternal death. Objectives: The objective of this study is to determine factors causing maternal deaths and to discuss the utility of medicolegal knowledge in ascertaining the causes of maternal deaths. Materials and Methods: This was a retrospective study where individual records of all maternal deaths brought for autopsy in the hospital mortuary during the past 10 years from January 2011 to December 2020 were studied. The cause of death and the factors which led to death in each individual case were analyzed. Results: A total of 15 maternal deaths were brought during the study period. Most maternal deaths (40%) occurred in the age group of 31-40 years. Maximum of the cases 11 of 15 were able to reach a health-care center before delivery. Direct causes accounted for 86.67% of maternal deaths. Hemorrhage and shock (38.46%) were the major direct cause of maternal deaths. The majority of the deaths occurred during the postnatal period (53.33%). Regarding the pregnancy outcome, 8 (53.33%) mothers were able to deliver live-born babies, of which 5 (62.5%) were delivered by lower segment cesarean sections and 3 (37.5%) by normal vaginal deliveries. Conclusion: There is scope for improvement as a large proportion of the observed deaths are preventable. Improving the rural health centers, upgrading the referral centers with round-the-clock functioning blood banks is the need of the hour.