Maternal mortality at a tertiary care teaching hospital of rural Assam: A retrospective study with special emphasis on time interval from admission to death along with impact of late referral
Binoy Kumar Borah, Nikhil Ranjan Rajkhowa
Objectives: To assess the maternal mortality ratio, causes of maternal death, time interval from admission to death with impact of late referral at a tertiary care teaching hospital of rural Assam. Method: A retrospective hospital based study of 88 maternal deaths over a period of three years from January 2013 to December 2015. The information regarding time interval between admission and death, details of referral status, demographic profile and reproductive parameters are collected and results are analyzed by using percentage and proportions. Results: Over the study period, there were 20333 deliveries giving maternal mortality ratio (MMR) of 446.38 per 100,000 live births. Most of the women died (n=65, 73.87%) within 12 hours of admission suggesting majority of the patients arrived at the tertiary care hospitals quite late. Most of the deaths occurred in the age group of below 25 years (n=69, 78.4%) and most of them are primi gravida (n=62, 70.4%). Most of the cases were unbooked, 65(72.73%). The number of direct causes were (n=76, 86.4%) in comparison to the indirect causes (n=12, 23.86%). The leading direct cause was eclampsia (n=40, 45.45%) whereas indirect leading cause was anaemia (n=11, 12.50%). Conclusion: Most of these maternal deaths were preventable by proper ante natal care, early referral, well equipped transport facilities and by more equipped tertiary care.