A study of maternal mortality in 8 principal hospitals in Pakistan in 2009

Objectives

To determine maternal mortality to assess the achievement of Millennium Development Goal 5 in Pakistan and suggest remedial measures.

Methods

Throughout 2009, maternal deaths occurring in obstetrics and gynecology departments in 8 hospitals in Rawalpindi and Islamabad, Pakistan, were recorded. A data form was filled in by the duty registrar at the time of death. Data were analyzed via SPSS.

Results

During the study period, there were 47 209 live births and 108 maternal deaths (age 17-45 years). Among those who died, 30% were primigravidas, 50% had a parity of 1-4, and 20% had a parity of 5 or more; 20.4% had not delivered, 40.7% had vaginal delivery, and 36.1% had cesarean delivery; 67.6% were unbooked and 32.4% were booked (14 under care of a consultant and 21 under care of a medical officer); 73%, 22%, and 5% died in the first, second, and third trimesters, respectively; 17.5% died prenatally, 4.6% during labor, and 78% postpartum; 73% were in a critical condition and 8% were dead on arrival. Eclampsia, postpartum hemorrhage, and sepsis caused 23, 13, and 13 deaths, respectively.

Conclusion

Maternal death can be effectively managed by skilled care during pregnancy, childbirth, and the postnatal period.