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Maternal deaths due to indirect causes: Report from a tertiary care center of a developing country
Nazli Hossain1, Zeenat F Shaikh1
1Department of Obstetrics & Gynecology Unit II, Ruth Pfau KM Civil Hospital & Dow Medical College, Pakistan.
Objective:
To assess the causes of indirect maternal deaths.
Setting:
The Department of Obstetrics & Gynecology, of a tertiary referral center in Karachi, Pakistan, from January 2018 to December 2020. Maternal deaths were categorized according to World Health Organization guidelines into direct and indirect deaths.
Result:
The total maternal deaths during the study period were 96, with 26 (27%) due to indirect causes. The mean age in the indirect group was 27 (range: 20-35) years, with only eight (31%) registered (attending for three of more antenatal visits). The mean gestational age was 33 (range: 22-39) weeks. Cesarean section was the main mode of delivery, in 13 (50%). Perinatal mortality was 68%. Cardiac and hepatic diseases (each six deaths, 23%) were the main causes of indirect maternal deaths. The majority of women (20; 76%) died during the postpartum period. Delays in seeking medical help, referral, and appropriate treatment were observed in 10, 9, and 7 cases, respectively.
Conclusion:
Indirect maternal deaths are an important cause of maternal mortality.
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