Maternal mortality at a tertiary care teaching hospital in Dibrugarh district, Assam: a retrospective study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20173842Keywords:
Maternal mortality, Tertiary care, Anaemia, DibrugarhAbstract
Background: Maternal mortality is a measure of quality of health care in a community. Assam has the highest maternal mortality rate among all India’s states, which is almost double the national average, with around 328 deaths per 100 000 live births. Three quarters of these deaths are among the tea plantations community. It has serious implications on the family, the society and the nation. Maternal mortality rate (MMR) is a very sensitive index that reflects the quality of reproductive care provided to the pregnant women. The objective of the study was to assess the Institutional maternal mortality and the causes of maternal death over a period of a year at a Tertiary Care Teaching Hospital in Dibrugarh district, Assam.
Methods: A retrospective hospital based study of maternal death cases from September 2015 to August 2016 was conducted to assess the maternal mortality. The study was carried out in the Obstetrics and Gynaecology Department of Assam Medical College and Hospital (AMCH), Assam. The study included 48 maternal deaths in the year. The information regarding reproductive parameters was collected from the maternal death register and the results were analyzed by using percentage.
Results: Out of 9789 total deliveries, Institutional Maternal Mortality was found to be 490 per 1, 00,000 live births. The maternal death was high among the Tea Garden community (66.7%) at the age group 15–20 years and was prevalent mainly in the illiterates (31.3%). Anaemia (29.1%) was the leading cause of death; followed eclampsia (23.0%) and septicaemia (17.0%) while cardio respiratory failure was indirect leading cause for maternal deaths.
Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths were preventable. Most maternal deaths can be limited by utilisation of existing medical facilities and identifying the barriers in accessing health delivery system. Early identification of high risk pregnancies and regular ante-natal check up with timely referral to tertiary care centre can help reduce the mortality among the women.
References
The Indian Trust for Innovation and Social Change (ITISC) - A study on the Socio-Economic causes and Determinants behind Infant mortality and maternal mortality. Sponsored by the Planning Commission of India. 2006.
The WHO application of ICD 10 to deaths during pregnancy, childbirth and the puerperium: ICD – MM, 2012.
Taye MK, Alam A, Rakshita. Retrospective evaluation of causes and social correlates of maternal deaths at Assam Medical College and Hospital Dibrugarh, Assam, India. J Evolution Med Dent Sci. 2016;5(5):275-9.
WHO Library Cataloguing-in-Publication Data “Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.
Cousins S. Assam: India’s state with the highest maternal mortality. BMJ. 2016;353:1908.
Amitava P, Prasanta R, Samir H, Mondal TK. Review of changing trends in maternal mortality in a rural medical college in West Bengal. J Obstet Gynecol India. 2005;55:521-4.
Fernandes S, Prabhu P, Chunha PD. Maternal Mortality at a tertiary care teaching hospital in South India: 10 years Retrospective Study. Int J Med Health Sci. 2015;4(3):327 -31.
Purandare N, Chandock AS, Upadhya S, Sanjanwala SM, Saraogi RM. Maternal mortality at a referral centre: a five year study. J Obstet Gynecol India. 2007;57(3):248-50.
Yadav K, Namdeo A, Bhargava M. A Retrospective and Prospective Study of Maternal Mortality In A Rural Tertiary Care Hospital Of Central India. Indian J Community Health. 2013;25(1):16-21.
Office of Registrar General, India. Special Bulletin on Maternal Mortality in India 2010-12. Sample Registration System (SRS). December 2013. Available at www.censusindia.gov.in/vital_statistics /SRS_Bulletins/MMR_Bulletin-2010-12.pdf.
Bangal VB, Giri PA, Garg R. Maternal Mortality at a Tertiary Care Teaching Hospital of Rural India: A Retrospective Study. Int J Biol Med Res. 2011;2(4):1043–6.
Peter M. World Health Organization, UNFPA. Pregnant adolescents: Delivering on global promises of hope, 2006.
UNFPA. State of World Population 2004: The Cairo Consensus at Ten: Population, Reproductive Health and The Global Effort to End Poverty. 2004. Available at: https://www.unfpa.org/sites/default/ files/pub-pdf/swp04_eng.pdf Accessed on 4 June 2017.
Murthy BK, Murthy MB, Prabhu PM. Maternal Mortality in a Tertiary Care Hospital: A 10- year Review. Int J Prev Med. 2013;4(1):105–9.
Thomas B., Mhaskar A. Review of maternal mortality at tertiary care hospital of India over ten years, Int J Gynecol Obstetr India. 2006;9(5):19-21.
Poojan D, Gupta KB. A study of maternal mortality at a tertiary institute. Obs. and Gynae. Today. 2009;115:58-60.
Kaur D, Kaur V, Yuel VI. Alarmingly high maternal mortality in 21st century. JK Sci. 2007;9(3):123-6.
Halder A, Vijayselvi R, Jose R. Changing perspectives of infectious causes of maternal mortality. J Turk Ger Gynecol Assoc. 2015;16:208-13.
Abou ZC. Maternal mortality overview. In Murrary CJL, Lopez AD (eds). Health, dimensions of sex and reproduction, Geneva. World Health Organization. 1998;111:64.
