Maternal mortality in a tertiary care hospital: a five-year review

Manjeet Kaur, Manjit K. Mohi, Sangeeta Aggarwal, Balwinder Kaur


Background: This study was aimed at analyzing the maternal mortality ratio over five years, the causes leading to maternal deaths in a tertiary care hospital and factors which are preventable.

Methods: The records of maternal death from August 2010 to July 2015 (5 years) were collected and analyzed. Various factors like maternal age, parity, literacy, place of residence, antenatal registration, admission-death interval, mode of delivery and causes of deaths were reviewed.

Results: The mean maternal mortality ratio (MMR) was 1039. The direct causes of maternal mortality were hemorrhage (22.4%), eclampsia (21.2%), sepsis (18.78%) and amniotic fluid embolism (8.48%). Indirect obstetric deaths were due to hepatitis (10.9%), anemia (3.6%), respiratory diseases (6.06%), heart diseases (3.03%), CNS disease (5.45%).  Most of the deaths (69.7%) occurred in age group 20 and30 years. 63.6% were multigravida and 85.4% were unbooked cases.

Conclusions: Antenatal care, screening and management of high risk pregnancies are most important to prevent complications and maternal deaths by timely detection and intervention.


Direct obstetric death, Indirect obstetric death, Maternal deaths, Maternal mortality, MMR

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International statistical classification of Diseases and Related Health Problems, Tenth Revision (ICD 10). Geneva, Switzerland, World Health Organization 1992. Available at

Maternal Mortality Ratio Bulletin 2011-13. Available at

Ronsmans C, Graham WJ, Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. Lancet. 2006 Oct 6;368(9542):1189-200.

Kassebaum NJ, Barber RM, Bhutta ZA, Dandona L, Gething PW, Hay SI et al. Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1775.

The Millennium Development Goals Report. May 2015, New York: United Nations; 2015. Available at

Puri A, Yadav I, Jain N. Maternal mortality in an urban Tertiary care hospital of north India. J Obstet Gynaecol India. 2011;61:280-5.

Jain M, Maharahaje S. Maternal mortality: A retrospective analysis of ten years in a tertiary hospital. Indian J Prev Soc Med. 2003;34:103-11.

Jadhav AJ, Rote PG. Maternal mortality–changing trends. J Obstet Gynaecol India. 2007;57:398-400

Murthy BK, Murthy MB, Prabhu PM. Maternal mortality in a tertiary care hospital: a 10-year review. Int J PrevenMed. 2013 Jan;4(1):105.

Pal A, Ray P, Hazra S, 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.

Onakewhor JU, Gharoro EP. Changing trends in maternal mortality in a developing country. Niger J Clin Pract. 2008;11:111-20.

Saini V, Gupta M. Review of maternal mortality in an urban tertiary care hospital of North India. Int J Basic Appl Med Sci. 2014;4(1):59-64.

Wadhwa L, Gupta S, Jain A. Demography and aetological profile of maternal mortality cases at a tertiary care centre of India-five and half years retrospective analysis. Indian J Med Specialties. 2013;4(2):238-242.

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.