• Bushra Khan
  • Farhat Deeba
  • Samina Naseem Khattak


Background: Maternal mortality ratio of a country is indicative of its health anddevelopment status. Information on maternal mortality is required to determine this statusand to set priorities for policy making and programmatic and operation research strategies.This study was conducted to determine the causes of maternal mortality in a tertiary carehospital. Methods: This study was conducted in Department of Obstetrics & GynaecologyB Unit, Ayub Medical College, Abbottabad, from January 2002 to January 2012. Data of allthe pregnant patients admitted to Obs/Gyn Unit ‘B’ Labour Room were retrospectivelycollected and reviewed for the causes of direct maternal deaths. Results: There were 21,120deliveries during the study period. Out of these, there were 163 maternal deaths. Thematernal mortality ratio was calculated as 772 per 100,000 live births. Direct maternaldeaths constituted 143 (87.7%) and indirect deaths were responsible for 20 (12.3%) deaths.Haemorrhage was the leading cause of maternal death and was responsible for 43.55% ofmaternal deaths, while eclampsia was observed in 26.99% of maternal deaths. In 6.13% ofpatients rupture uterus was the cause of maternal death. Conclusion: Maternal mortality inour part of the world is high and most of the causes of maternal death remain haemorrhageand eclampsia. Haemorrhage which is the leading cause of maternal death is bothpredictable and preventable, if proper peripartum care is provided, maternal mortality canbe reduced.Keywords: Maternal mortality, Eclampsia, Septicaemia, Haemorrhage, Pulmonaryembolism


Maternal mortality in 2000, Estimates developed by WHO,

UNICEF and UNFPA, Geneva, Switzerland. WHO: 2004.

Available at:


Berg C. Strategies to reduce pregnancy related deaths: from

identification and review control and prevention, 2001. Available

at: health/02-pub-elec.htm

Zahr CA, Royston E. Compilers Maternal Mortality –a global

fact book. Gereva: WHO; 1991.

Jaffery SN. Review of maternal mortality over 10 year period at

JPMC Karachi. J Pak Med Assoc 1972;22(3):71–61.

Mother-Baby Package: Implementing safe motherhood in

countries .World Health Organization, Geneva, 1994. Available



Tinker AG. Improving women’s Health in Pakistan, Human

Development Network, Band, 1998.

World Health Organization. Maternal Mortality in 2005.

Estimates developed by WHO, UNICEF, UNFPA and the World

Bank. Geneva: WHO; 2007.

Khan YP, Bhutta SZ, Munim S, Bhutta ZA. Maternal health and

survival in Pakistan: issue and optimus. J Obstet Gynaecol Can


J Ayub Med Coll Abbottabad 2012;24(3-4) 127

Drife J. Maternal Mortality: National and international

perspectives. In: Gjorgov AN, (Ed). The year book of Obstetrics

and Gynaecology. Vol. 8. California: Karger; 2000.p. 91.

Maternal mortality. World Health Statistics. WHO Bull


Family and reproductive health coverage of maternity Care.

Society of Obstetrician and Gynecologists Pakistan. SOGP

Survey 1989-90 Pakistan. WHO 1997.

Fikree FF, Midhet F, Sadruddin S, Berendes HW. Maternal

mortality in different Pakistani sites: ratios, clinical causes and

determinants. Acta Obstet Gynecol Scand 1997;76:637–45.

Sarin AR, Singla P, Kaur H. Maternal mortality-aetiological

factors: analytic study from a teaching hospital of Punjab. Indian

J Matern Child Health 1992;3(3):69–73.

Siddiqui GK, Hussein R, Dornan JC. Dying to give birth: the

Pakistan Liaison Committee’s strategies to improve maternal

health in Pakistan. BJOG 2011;118(Suppl 2):96–9.

Begum S, Aziz-un-Nisa, Begum I. Analysis of maternal

mortality in tertiary care hospital to determine causes and

preventive factors. J Ayub Med Coll Abbottabad 2003;15:49–52.

Fawad A, Naz H, Islam A, Zafar S, Abbasi A. Maternal

Mortality in a tertiary care hospital. J Ayub Med Coll Abbottabad


Baloch R. Prevalence of maternal mortality: a critical problem in

rural population. Pak J Obstet Gynaecol 1997;10:6–9.

World Health Organization. Summary of maternal mortality

estimates. Geneva: WHO, 2002. Available at:


WHO/UNICEF/UNFP Maternal Mortality Report in 2000.

Geneva: WHO; 2000.

Motashaw, Nergesh D. Root causes of maternal mortality:

Infancy to mother hood. J Family Welfare 1997;43(2):4–7.

Rahim R, Shafqat T, Faiz NR. An analysis of direct causes of

maternal mortality. J Postgrand Med Inst 2006; 20:86–91.

Safe Motherhood, Fact Sheet. Revised 1990 estimates of

maternal mortality. A new approach by WHO and UNICEF

Geneva: World Health Organization; 1996.

Rviz-Rosas RA, Rocio Cruz-Cruz P, Torres-Arreola L.

Obstetrical hemorraghge as a maternal death cause in the

Instituto Mexicano del Seguro Social during 2011. Rev Med Inst

Mex Seguro Soc 2012;50(6):65–4.

Shaheen B, Hassan L, Obaid M. Eclampsia a major cause of

maternal mortality: A prospective analysis at a tertiary care

hospital of Peshawar. J Pak Med Assoc 2003;53:346–50.

Lodhi SK, Khanum Z. Maternal mortality at Lady Willington

Hospital, Lahore. Ann King Edward Med Uni 2002;8:286–8.

Shah N, Hossain N, Shoaib R, Hussain A, Gillani R, Khan NH.

Socio-demographic characteristics and the three delays of

maternal mortality. J Coll Physicians Surg Pak 2009;19(20):95–8.

Jafarey S, Ahsan A, Kamal I. Manual for emergency obstetrics

care. UNICEF/National Committee for Maternal health 2000:4–10.

Hibbard MB, Anderson MM, Drife JO. Report on confidential

inquiries into maternal deaths in UK (1988–90) UK: Her Majesty

Stationary Office; 1994. p. 15–8.

Higgins D, Jones D. Ensuring patient safety blood Transfusion.

Nurs Times 2013;109(4):22–3.

Khan B, Khan B, Sultan R, Bashir R, Deeba F. A Ten Year

review of emergency peripartum hysterectomy in a tertiary care

hospital. J Ayub Med Coll Abbottabad 2012;24(1):14–7.




Most read articles by the same author(s)

1 2 > >>