Publication:

Analysis of maternal deaths: autopsy study at tertiary health care center

Background Every day thousands women died due to complications of pregnancy and child birth globally. Almost all of these deaths occurred in low-resource settings, and most could have been prevented. Maternal mortality is a health indicator that shows very wide gaps between rich and poor, urban and rural areas, both between countries and within them. The present study was carried out with view to determine factors causing maternal deaths, causes of maternal deaths and utility of autopsy with autopsy record as a useful and adjunct data source for ascertainment of maternal deaths.

Methods Total 95 cases of maternal deaths which were brought for postmortem were studied during period of August 2012 to July 2014.

Results Maximum number of maternal deaths were seen in age group of 21 to 25 years comprising 38 (40.0%) and with maximum cases from low socioeconomic strata. Analyzing the pregnancy outcome, live birth to child were given by 66 (69.5%) against negative outcome in 29 (30.5%) of cases. Post-partum hemorrhage remains the leading cause followed by sepsis 13 (13.7%) in direct causes of maternal deaths. In indirect causes hepatitis leads the list with 4 (4.2%) cases.

Conclusions Despite the improved methodology, global database on maternal mortality remains weak. Hence forensic pathologist plays important role in identifying these cases with appropriate cause of death. Review of autopsy findings along with hospital records can prove to be one of the useful sources to identify pregnancy related deaths and elucidating the emerging trends.