Maternal Mortality in Pakistan: An Attention Seeking Problem
Objective: Objective of the study was to determine the maternal mortality ratio and major causes of maternal mortality in different tertiary care hospitals representing each province of Pakistan. Study Design: Empirical study Duration & place of Study: Two years; from January 2014 to December 2015 at Sir Ganga Ram Hospital Lahore. Methodology: Data was collected from patients’ record from four tertiary care hospitals of the country. All maternal deaths due to direct or indirect causes were included in the study. Deaths of mother’s due to accidental or incidental causes were excluded. Data was analyzed and qualitative variables were calculated in percent while quantitative variables were measured using mean and standard deviation. Results: Total number of live births during the study period was 101010. Out of these, total maternal deaths were 456. Maternal mortality ratio was 451.4/100,000 live births. Mean age and parity of patients was 30.6±6.1 years and 4.0±3.0 respectively. Maternal deaths due to direct causes were 373 (81.8%), due to indirect causes were 81 (17.8%) and in 2(0.4%) cases, the cause was unknown. Most common direct cause of maternal mortality was haemorrhage in 151(33.1%) patients followed by hypertensive disorders in 103(22.6%), sepsis in 43(9.4%), pulmonary embolism in 27(6%), obstructed labour in 28(6.1%), anesthesia complications in 10 (2.2%), ruptured ectopic pregnancy in 7(1.5%) and acute fatty liver of pregnancy in 4(0.9%). The most common indirect cause was anemia in 31(6.8%) patients followed by acute hepatitis in 28 (6.1%), cardiac disease in 17(3.7%) and anaphylactic reaction in 4(0.9%) cases. Three hunded and forty (74.6%) maternal deaths were in postpartum period. Only 60(13.2%) mothers registered their pregnancy for antenatal care. Conclusion: Maternal mortality ratio is alarmingly high in our country. Hemorrhage & anemia are identified as the leading direct & indirect causes of maternal death respectively. Both can be prevented by improving antenatal care and strengthening emergency obstetric services.