[Maternal mortality in the Hospital Central Militar. Report on 25 years: 1968-1991]

A total of 122 cases of maternal death are reported. These cases occurred at the Hospital Central Militar, a 3rd. level general hospital, during the period of 25 years from 1968 to 1992. Maternal mortality rate was 181.7 x 100,000 live births (143.0 when non-obstetrical deaths were eliminated according to the World Health Organization recommendation). Annual and quinquennial variations were very width and erratic. Ninety cases were classified as direct obstetrical deaths (73.77% of the total) and 26 (21.31%) as non-obstetrical ones. The principal causes of deaths were: infection, toxemia and hemorrhage. Approximately the half of the patients was between 16 and 25 years-old and had a parity between 2 and 4. Sixty-two cases were considered preventable deaths (50.52%) and 36 cases probably preventable ones (29.51%), with a total of 98 cases (80.03%) with any possibility of prevention. Responsibility in these 98 deaths cases were in 52 cases (53.06%) on physicians and hospital and 46 cases (46.94%) on patients and community. The conclusion of this work is that the maternal mortality rate in this hospital is very high, in part because a complete registration and also because of the no-exclusion of cases policy. These results reflects the national conditions of maternal health and not the one of the particular health system at which the hospital belongs.