Maternal deaths due to indirect causes: Report from a tertiary care center of a developing country

Abstract

Objective To assess the causes of indirect maternal deaths. Setting Department of Obstetrics & Gynecology, in a tertiary referral center in Karachi, Pakistan, from January 2018 to December 2020. Maternal deaths were categorized per World Health Organization guidelines into direct and indirect deaths. Result The total maternal deaths during the study period were 96, with 26 deaths (27%) due to indirect causes. The mean age in the indirect group was 27 (range: 20–35) years, with only eight (31%) registered. 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. A 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.