Maternal Mortality in Services Hospital Gyane Unit II in the Year 2010

Abstract

Abstract

Objective:  To determine frequency of maternal mor-tality in the tertiary care setting and any recurrent risk factors.

Study Design:  Retrospective Observational Study.

Place and Duration of Study:  Gynae unit II Services Hospital Lahore. Maternities presenting in 1 year from 01 November 2009 to 01 November 2010.

Patients and Methods:  Pregnant patient presenting in Gynae unit II. These included 1^st trimester pregnancies (for ectopic and septic miscarriage).

Results:  Total number of maternities presenting in Gynae unit II, Services Hospital Lahore during this time period were 4080. Total number of maternal dea-ths was ten that makes it 1 in 408. Out of these hae-morrhage was the leading cause 50% seconded by indirect cause of cardiac disease 20% followed by Sepsis (10%), Ectopic (10%) and HELLP (10%). Age group ranged from 24 - 37 - < 30 were 7 and > 30 were 3. Half of the patients were > G₅ and other half fell in lesser parity. All died during hospital stay. Two patients were booked. Out of the five hemorrhaging patient 4 had IUD and 2 patients were at 28 weeks and the rest were at 35 to 36 weeks. Both cardiac patients are below 30 weeks (25 and 29).

Conclusion:  IUD haemorrhage and DIC were recur-rent causes. Most of the patients had IUD at presenta-tion resulting in FSB at they had bleed substantially at home before presenting. Ectopic took its toll but was compounded by blood reaction. Effective, efficient, quick and well equipped blood bank services are a must, only and definite way to decrease the maternal mortality. There is a need to make protocols and man-age such haemorrhaging patients by a multi disciple-nary team specially created, trained and updated for this purpose. Public education and awareness about risks of pregnancy, booking benefits and quick referral to hospital. Measure to impose access of patients to well equipped health factors.  We need to further study the quality of care and do risk management as effecti-vely followed by NHS.