Maternal Mortality In Pakistan: Is There Any Metamorphosis Towards Betterment?

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• Maternal mortality remains a critical issue, particularly in developing nations, with preventable causes like hemorrhage, hypertensive disorders, sepsis, obstructed labor, and unsafe abortion contributing to over half a million deaths annually.
• Pakistan faces a significant burden of maternal deaths, necessitating detailed analysis of trends and causes within its healthcare system.

Purpose of the Study:

• To assess the maternal mortality rate (MMR) in a tertiary care hospital in Sindh Province, Pakistan.
• To analyze trends in maternal mortality over a 20-year period (1986-1995 and 2011-2015).

Main Methods:

• Retrospective analysis of maternal mortality records from 1986-1995 and 2011-2015.
• Data categorized into four 5-year periods for trend comparison: 1986-1990, 1991-1995, 2006-2010, and 2011-2015.

Main Results:

• The cumulative maternal mortality ratio (MMR) was 1521.5 per 100,000 live births.
• A downward trend in MMR was observed, decreasing from 2368.6 in 1986-1990 to 1265.1 in 2011-2015.
• Direct causes accounted for 84.78% of maternal deaths, with sepsis being the leading cause in the earlier period and eclampsia in the later period.

Conclusions:

• Despite a downward trend, the reduction in maternal deaths has been slow.
• Direct obstetric causes continue to be the primary drivers of maternal mortality.
• Targeted interventions addressing sepsis and eclampsia are crucial for further reducing maternal mortality in Pakistan.