Maternal mortality at a tertiary care center-an autopsy study

Background: Maternal mortality is a global health problem. WHO claims some progress towards reduction in maternal mortality especially in the past decade. The key requirement in further reduction is to understand the causes of deaths and formulate effective policy and health program strategies. Aims: Evaluation of causes of maternal deaths based on autopsy findings as per categorization of WHO application of ICD 10 MM. Materials and Methods: The present study comprised of 155 cases of maternal deaths .The complete autopsy was done by a team of pathologist and forensic experts. Detailed external, in situ and gross examination of organs was done. Representative bits from all organs were taken and processed as per the standard protocol. Slides were examined jointly by two pathologist and final opinion was formulated to know the cause of death. All deaths were categorized as per WHO application of ICD 10 MM. Results: Direct causes of maternal deaths outnumbered indirect causes. Amongst direct causes obstetric haemorrhage 29.68% was the leading contributor followed by PIH (21.29%). Amongst indirect causes of maternal deaths a wide range of causes were found involving different systems. . Contributory causes were found in (86)56.13 % of cases. Conclusion: Majority of maternal deaths were due to direct causes ( 62.58%). Potentially preventable causes were haemorrhage and sepsis. Present study encourages categorization of maternal deaths as per WHO application of ICD10MM coding system as it gives leading and contributory causes of maternal deaths and helps us in formulating a meaningful clinical groups and makes us understand the areas of weakness to formulate effective health care strategies.