Main Article Content
OBJECTIVE: To determine the frequency of maternal mortality and identify causes with age groups in tertiary care hospital of Peshawar, Pakistan.
METHODOLOGY: A descriptive study conducted at Gynecology & Obstetrics units of Lady Reading Hospital, Peshawar, Pakistan. with retrospective review of validated records of hospital registers from January 1st January 2009 to 31st December 2011. Convenience sampling used to access the records. A self structured proforma designed to collect validated data on variables (age, cause of death, year of death, place of residence), that were analyzed in Excel- 2007 and trend analysis determined by Joinpoint Analysis Software.
RESULT: A total of 277 maternal deaths recorded from Lady Reading Hospital in three years. Hemorrhage remains the leading cause with 27.07% (CI= 0.66, SD= 5.65) followed by eclampsia 15.88 % (CI= 0.60, SD= 5.13), ruptured uterus 10.83% (CI= 0.51, SD= 4.35) and sepsis 10.10% (CI= 0.47, SD= 4.04). Maximum maternal deaths of 33.57 % reported in 26- 35 years, followed by 26.71 % in 15- 25 years, 23.10 % in 36- 45 years and 3.24 % in 45- 55 years and 6.13 % deaths reported from unknown age group as well. Post Partum hemorrhage was significant with P-value (0.002).
CONCLUSION: Maternal mortality remains high with leading causes as hemorrhage, eclampsia, ruptured uterus and sepsis in women of 26- 35 years age groups. A strong need to improve the maternity care in tertiary care hospitals and community based education is emphasized for the awareness of the masses, to prevent these deaths.
KEY WORDS: Maternal Mortality, Childbearing age, Eclampsia, Postpartum Hemorrhage, Ruptured uterus.
Work published in KMUJ is licensed under a
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
2. Determinants of Maternal Mortality: A Thorn Remains In Our Side. Karachi: JPMS; 2013. http://blogs.jpmsonline. com/2013/07/08/determinants-of-mater¬nal-mortality-a-thorn-remains-in-our-side/
3. Drife J. Maternal Mortality: National and International perspectives. (2000) In: O Brien PMS. The Yearbook of Obstetrics and Gynaecology. RCOG Press. London. Vol 8 (edi) 2000:91.
4. World Health Organization. MDG 5: im¬prove maternal health. [Cited on Decem¬ber 28, 2014]. Available from URL: http:// www.who.int/topics/millennium_develop¬ment_goals/maternal_health/en/
5. Trends in Maternal Mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. [Cited on December 28, 2014]. Available from URL: http://apps.who.int/iris/bitstre am/10665/112682/2/9789241507226_ eng.pdf
6. Ministry of Planning, Development and Reform. Government of Pakistan. Pakistan Millennium Development Goals Report 2013. [Cited on October 20, 2014]. Available from URL: http://www.undp. org/content/dam/pakistan/docs/MDGs/ MDG2013Report/UNDP-Report13.pdf
7. Khan SM, Saleem M, Razzaq A. Incidence of near-miss maternal mortality in the department of obstetrics & gynaecology Sh. Zayed Medical College / Hospital, Rahim Yar Khan. Pak J Med Health Sci 2010;4(1):44-5.
8. Fahim F, Nabeel N, Utman N. Trends in Maternal Mortality in tertiary care hospital in Peshawar - Pakistan. J Postgrad Med Inst 2012; 26(4): 422-7.
9. Begum S, Aziz-un-Nisa, Begum I. Analysis of Maternal Mortality in a Tertiary Care Hospital to determine causes and pre¬ventable factors. J Ayub Medical College, Abottabad, 2003;15 (2): 49- 52.
10. Rahim R, Shafqat T, Faiz NR. An analysis of direct causes of maternal mortality. J Postgrad Med Inst 2006;20(1):86–91.
11. Jabeen M, Gul F, Rahman M. Maternal mortality ratio and its causes in A district headquarter hospital of NWFP. J Postgrad Med Inst 2005;19(4):377-81.
12. Ara S, Tahir S, Rehman A. Maternal mortality in Faisalabad and millenni¬um developmental goals Pak J Med Sci 2012;28(3):371-5
13. PDHS, National Institute of Population Studies & Demographic and Health Sur¬veys. Pakistan Demographic and Health Survey. 2006–2007.
14. Khan B, Deeba F, Khattak SN. Maternal mortality: a ten year review in a tertiary care setup. J Ayub Med Coll Abbottabad 2012;24(3-4):124-7.
15. Butt MA. Women’s Health Problems in Pakistan. Middle East J Fam Med 2004; 2 (2):1-17
16. PAKISTAN: Special report on maternal mortality. Pakistan: Human Development Foundation; 2004. [Cited on December 08, 2014]. Available from URL: http:// www.yespakistan.com/wellness/maternal. mortality.asp
17. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000; 19:335-51. (correction: 2001; 20:655).
18. National Cancer institute, Surveillance Research. [Cited on January 04, 2015]. Available from URL: http://surveillance. cancer.gov/joinpoint/
19. Nisar N, Sohoo N. Maternal mortality in rural community: a challenge for achieving millennium development goal. J Pak Med Assoc 2010; 60: 20-24.
20. Jafarey S. Maternal mortality in Paki¬stan--compilation of available data. J Pak Med Assoc 2002;52(12):539-44.
21. Shaheen BI, Obaid HM. Eclampsia, a Major Cause of Maternal and Perinatal Mortality: a prospective analysis at a tertiary care hospital of Peshawar. J Pak Med Assoc 2003; 53: 346-50.
22. Shah N, Hossain N, Noonari M, Khan H. Maternal mortality and morbidity of unsafe abortion in a university teaching hospital of Karachi, Pakistan. J Pak Med Assoc 2011; 61: 582-6.
23. Soomro S, Naz S, Memon N, Baloch R. Causes of maternal deaths at a tertiary care hospital. Rawal Med J 2013;38(3):271- 4.
24. Shah RJ, Ali I, Banday A, Fazili A, Khan I. Analysis of Maternal Mortality in a Small Teaching Hospital Attached to Tertiary Care Hospital (A 10 yr review). Indian J Community Med. 2008; 33(4):260-2.
25. Iftikhar R. A Study of Maternal Mortality. J Surg Pak (International) 2009; 14(4):176-9.
26. Kassebaum NJ, Bertozzi-Villa A, Cogge¬shall MS, Shackelford KA, Steiner C, Heu¬ton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384(9947):980-1004.
27. Montgomery AL, Ram U, Kumar R, Jha P, for The Million Death Study C. Maternal Mortality in India: Causes and Healthcare Service Use Based on a Nationally Rep¬resentative Survey. PLoS ONE. 2014; 9(1):e83331.