Causes of Maternal Death in Dhaka Medical College Hospital (DMCH)

21/02/2013 20:19

Maternal death may be due to either direct or obstetric causes resulting from complications of pregnancy, labour and puerperium (70 - 80%) or indirect causes those are associated medical disorders complicating pregnancy (20 - 25%). Besides these clinical causes there are contributory factors e.g. socio-economic, organizational and environmental. The common causes are–

• Haemorrhage
• Sepsis
• Unsafe abortion
• Prolonged or obstructed labour
• Hypertensive disorders of pregnancy especially eclampsia⁴.

The commonest single preventable cause is obstetric haemorrhage which is responsible for 25 - 50% of maternal deaths³. Atonic postpartum haemorrhage is the most important cause among obstetric haemorrhage, followed by antepartum haemorrhage (APH), rupture of the uterus and ectopic gestation. Septic abortion is an important cause of death specially in Bangladesh and India³.

The contributory causes are:

• Poverty, under nutrition, female illiteracy and gender differences are the important social factors.
• Poor perinatal care : the poorer the perinatal care, the more unsafe the motherhood, delay in seeking medical care, absence of skilled birth attendance at delivery, poor transport facilities etc are  important contributory factors.